Perineal reconstruction?

Submitted by reka108 on April 6, 2007 - 2:01pm
Body: 

A few days ago I went to see the top urogynecologist of my country. he graded both of my celes as grade 2/3 which did not surprise me in the light of recent developments. :-(

However, he did not recommend surgery because he thought things might still improve once I stop breastfeeding (well, I don't think he knew that I plan to do that in 2-3 years time, lol).

But he did recommend to do some 'plastic surgery' on my perineal body. The stiches did not hold there and therefore my vaginal opening is very long. He thought that such a correction would greatély improve stability in the whole region. He did not think it would help the celes at all but that my comfort would be much better. I can see his point because one of my main problems is feeling that everything is very open and that something might fall off...

Did anyone heard of such a thing? Did anyone have scars revisited this way?
Of course, I am a bit worred about how sex will be effected by this. Could it make things painful?

I would appreciate your input on this.

By the way, he also said that his experience with post-partum prolapse is that it is almost always caused by the doctor's negligence! (I gave birth in another country, so he was not afraid to say so...)

granolamom

April 6, 2007 - 3:17pm

a long while ago I toyed with that idea. I've had pretty bad tearing up of my perineum and thought that might help.
but I'm chicken, and afraid surgery might lead to scarring or adhesions or painful intercourse or.....
and right now the symptoms I have are manageable.

if you look into it, please do let me know what you find out

reka108

April 6, 2007 - 4:39pm

Hi Granolamom,
I have found that thread you started some time ago...
I really don't know what to do. Anyway, apparently they cannot accommodate nurslings at the hospital so I won't be able to have this done anytime soon.
I give the WW method a few more months and then will decide whether to have this thing done or not - and continue the WW things irrespectively of that decisison :-)

Reka xxx

granolamom

April 7, 2007 - 8:51pm

yep, that's the nice thing about this work...you have all the time in the world. you can always decide later, as far as I know, the surgeons won't be closing up shop any time soon.

alemama

April 13, 2007 - 10:41pm

sorry this took me so long.....After my third baby ( but before I knew about my prolapse) I went to see a surgeon about my tear- I had stitches but they didn't hold and I felt like I had this gaping opening so with a referral I saw a surgeon. He gave me the breastfeeding schpeal too. But he also told me that I should just be patient- give it 3 months and see how I feel - that I would still do much more healing- it would be slow. I can now (6 months later) kegal the opening closed (I looked in a mirror). the tear is still there but the supporting muscles have done a very good job of coming together-
I don't know if this gives you any hope- but my tear was severe.
Also when he described the process of restitching the tear I was pretty discouraged- debridement- ugh and then six weeks healing time - I just couldn't imagine volunteering for that right now-

reka108

April 14, 2007 - 5:07am

What do you mean by Kegeling the opening closed? In fact, I have just realised, I do not know what constitutes the 'opening'. Do you mean that when you do a Kegel contraction your urethral opening also disappears together with the entrance to the vagina? Do you do that standing up or lying down?

A week ago for me closing the opening even on my back would have been very far off but now that I have started work with this 'healer' of mine it is almost possible! Not standing, of course, because then there is my cystocele in the way...

I am hopeful that even if my celes do not respond to the treatment at least I won't need the reconstruction work.

Rekaxxx

granolamom

April 14, 2007 - 8:43pm

what do you mean by 'kegeling the opening closed'?
the vaginal opening?
the area that tore and didn't properly heal?
I can't get a muscle twitch going at the edges of my tears. It feels like more than just skin, so I'm thinking there's some muscle involvement, but who knows really.

and yeah, the thought of debridement, 6 weeks healing, possible scarring and adhesions....I'd rather have the problems I know about.

but still I think about it from time to time...

alemama

April 14, 2007 - 9:22pm

my tear approximates really well-the edges of the tear line up- that is the one part of my tear that was not discouraging- but yes I mean the vaginal opening- and lying down - I think standing the opening is pretty full of prolapse.....but I haven't looked recently. The torn part is always touching unless spread- so at first glance it doesn't look torn- but I can move the skin a little and I have maybe a half inch of tissue that was at one time together and now isn't. I know a half inch doesn't seem like much but the whole area just isn't that large (maybe an inch between openings).
I am not supporting kegals as help for anything- I just wanted to put it out there that even though I have an unstitched tear the muscles are still able to do pretty much what they were able to do before they were ripped apart- so I don't have any real knowledge of what is going on with the muscles and how they are coming together or anything like that but in my estimation if I can manage to use them to close the vaginal opening then I really don't "need" to have a repair-
I think it would provide some superficial support if the tear was repaired but not a whole lot of structural support.
I hope this makes more sense and I did a better job of explaining why I even posted this here-

and one more thing.....I have read here about episiotomy scar tissue break down- so I figure I go through the whole repair thing and then years down the road have it break down and cause pain- it is just another risk I don't really want to take unless it is necessary-