Khashayar Shakiba, MD, FACOG, FPMRS
Episiotomy wound problem 2017-10-16T17:54:50+00:00

 

Some women experience tears in the perineum at the time of childbirth from the forceful and excessive pushing, especially for women who endure a lengthy laboring process, while others require surgically cutting of the perineum in order to provide a greater diameter for the newborn to emerge from. In most cases, the torn or cut muscle (perineum) is repaired properly with little to no long term side effects. However, in some cases, the repair is not done or does not heal properly and causes long-term discomfort to mothers.

The wound may have been closed too tightly, creating a very small opening of the vagina. This can cause intercourse to be excruciatingly painful upon entrance of one’s partner. Although discouraging, the perineum is a muscle and will stretch when manipulated to do so, and Dr. Shakiba has efforts that aide in stretching out the vaginal opening without surgery. The downside to this approach is that it is a slow process, as you do not want to stretch too far too quickly as the perineum has the potential to tear yet again. A surgical alternative to recut and re-repair the perineum, resulting in a more appropriate diameter is also an option. This alternative is less timely and requires only a minimal recovery time.

In other circumstances, the wound may not have been closed properly, leaving slack to the anal sphincter, causing fecal incontinence. In these cases, a woman’s economic and social life can be devastatingly affected and surgical intervention should be strongly considered.

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