The Perineum is the area of tissue between the vagina and the rectum. Childbirth can cause tearing and scarring of the perineal tissue. Oftentimes, the healing process of these tears leads to uneven scarring and disfiguration of the perineum. This condition often results in vaginal looseness.

Perineoplasty is a surgical procedure to tighten the entrance of the vagina or correct damage to perineal tissue. This surgery repairs the damage and resurfaces the tissue in order to return the area to its ‘normal’ state. The procedure also rebuilds and tightens muscles. The entrance of the vagina will be narrowed, providing the additional benefit of vaginal tightness for intercourse.

The Procedure

Perineoplasty is an outpatient surgery and is performed under mild sedation with local anesthesia. The procedure usually takes between 30 and 45 minutes. A V-shaped incision is made in the back wall of the vagina, damaged or excess tissue is removed, and the muscles are stitched back together. A Perineoplasty is usually performed during a vaginoplasty, but the procedure can also be performed on its own.

Perineoplasty: the pre-operative aspect (left), and the post-operative aspect (right) of the surgical correction of the perineum. (Image credit Wikipedia)

 Post Procedure

Most patients return to work within a few days after this procedure. Pain is managed by over-the-counter or prescription medication. In the first few days, some minor bleeding is not uncommon and wearing a sanitary pad is recommended. The incision should be kept clean and dry. Stitches usually dissolve in about two weeks. Patients are advised to drink plenty of water and increase fiber intake to avoid constipation. Normal activities may be resumed in four weeks. Sexual Intercourse is discouraged until all areas are healed for around six to 8 weeks.