Who repairs and how do you find...

[Electra375]

Who repairs perineums? And how do you find such a doctor? The gyn I saw at 2wks PP says he can do the repairs, but I'm not wanting to have such a procedure done locally. I also want to see before and after photos and be sure that the doctor understands I don't want "vaginal tightening", I just want my perineum tissue reconstructed so I can stop having UTIs!!! I'm 4wks PP and on my 2nd UTI with antibiotics. (I am assuming bacteria from my anus is able to reach my urethra b/c of not having a perineal tissue distance anymore.)

I'm so distraught over my mw not surturing the upper layers of the perineal tissues, just the internal layers were surtured and still sore inside I might add.

Basically I have nothing between my vaginal opening and my anus, which if I found the right wording might be called Deficient Perineum.

Researching google is not getting me results of what I want. I came across the word Perineorrhaphy, but w 2 definitions and 1 is not anywhere near what I want (as in removal of the perieal tissues). And then I get a lot of sex reassignment type things, vaginal rejuvenation, and congential abnormality type stuff.

Maybe what I want can't be done??? It seems to logical in my head, MAKE MY TISSUES CONNECT BACK TOGETHER...

The gyn wanted to see me again between 6wks and 8wks PP. He lead me to believe at 8wks PP surgery would be an option. Well, I'd like to more than 1 opinion and 1 option, so I've been trying to research this now with 3wks to go.

My labia laceration is not healing anymore than it had 2 weeks ago. This all really just sucks. I thought well maybe I won't need to have surgery. It makes no sense to have this kind of surgery if we want more children, but I can't live on antibiotics. I'm not ready to make the decision of no more children permanent. Amazing the decision to have myself restored coinsides with a decision to not have anymore children and making a choice on permanent birth control which I do not believe is right... Like I said this all just really sucks.

[fuller2]

Oh boy, do I ever feel for you. I don't have any answers but I just wanted to say that I hope you find a way through this. Having my parts rearranged was the only thing that took me completely by surprise after my delivery---NOBODY told me how often this happens. It's so hard to deal with the fact that THIS has changed completely too.

Stupid and I hope not insulting question, but you are careful about how you wipe yourself etc.? Maybe you could make yourself take an extra 3 minutes in the bathroom so you could use the shower sprayer (if you have one) for a quick crotch/bum wash after every BM? (or spend thousands of dollars and install a bidet?? sigh.) If you can't repair your perineum yet, maybe this could at least help keep the bacteria at bay until you can.

Why don't you want the local anesthesia? They would probably give you a Valium or something so that you would be relaxed...

[Electra375]

Originally Posted by fuller2

Why don't you want the local anesthesia? They would probably give you a Valium or something so that you would be relaxed...

I meant locally as in my area/ town. I don't trust the hospital or doctors here at all, hence part of my reasoning for hbing.

I do clean well after using the toilet, I've still be using that peri bottle for washing off after every toilet visit to aid in healing my perineum. I use witch hazel after BMs.

I just found a thread that was all about the V shaped perineum, so hoping for healing more has been lost.

[MommytoTwo]

Would a plastic surgeon who specializes in reconstructive surgery be a choice?

[Defenestrator]

My local teaching hospital has a whole vulvar pain/vulvar disease/ clinic. If you have a regional medical center/teaching/research hospital in your area, you might look at their department of OB/GYn and see if they have any gynocological clinics which would provide the specialty services you need.

On the other hand, one of the doctors I respect most for perineal reconstructive surgery practices in a small town in a community hospital in a rural area of my state, so good docs can sometimes be found in strange places.

Good luck.

[mwherbs]

gyn is who is going to do this type of surgery
you may find a plastic surgeon but it would not be something that they do often-- a urologist that has a gyn specialty may be some one else to find-- that is who my mom went to most recently for a prolapsed bladder repair

[SwissMama]

I have the same thing, only it was the lower layers that were not sutured correctly, and the upper layers were over-sutured, sloppily, so there was a "cavern" underneath, with skin bridges over top. :

My OB cut the skin bridges, because even walking was so painful i would cry, but the rest has to be done with alot more anasthetic, so he put a note in my file for it it be done after my last childbirth. I have no idea what that means in terms of who does it, I have a meeting at the hospital in a month to discuss it.

So i have no advice : , just feeling for you.

[BetsyS]

I second the idea to find a regional teaching hospital. I would personally look for a gynourologist. I think they would be your best bet at good surgery.

And, I probably wouldn't go to just an ordinary gyn for this type of problem.

[liseux]

My close friend had a similar situation, she had a 4th degree that became a rectovaginal fistula. She wasn't open on the perineum after a few months, but had holes in between vaginal wall and anus. She had everything reconstructed at Fairfax Hospital with a very understanding surgeon and is very happy with the results. What they had to work with was very thin in her case so she did go on to have her next baby by c/s to protect the area. Her butt was the most affected part so the threat of a colstomy bag was her biggest reason for her avoiding vaginal birth. Feel free to pm me if you'd like the name of her surgeon.

[ustasmom]

Someone at church had that surgery. Very intense. I'm pretty sure that she was on an inverted board for the surgery. One of the GYNs at church knew of a doctor who did such surgeries. It took months to heal.

[Electra375]

Well, this birth is taking months to heal from. No stairs, no climbing in my van, no lifting, no straining of the perineum. Once I heal from this I won't be rushing off to surgery until I get things under control at my house, unless I'm in pain doing my everyday activities.

Plus dh and I have a lot of things to discuss before a decision can be made. But first we need someone to give their professional opinion and tell us what is involved in such a surgery. The gyn I saw at 2 wk PP isn't someone I would trust to perform surgery, he has a bad track record in our town and has been repremanded by the BOM plus lost his priviledges at our local hospital on 2 separated occassions. He's nice, but... nice isn't what counts here.

My ins does not list the specialty urology with gynocology. I'm probably going to have to call each one and ask. I did find in my research that the Univ of VA in Richmond has a clinic for this sort of thing. That is kind of a long way from here.

Mostly I just try not to think about this. Every time I look at what's going on or hold myself together for a BM, I get upset about it and sometimes cry. Just sitting is still very uncomfortable, throbbing, sore, achiness.

I know surgery will be NO FUN at all. I don't want to be down for monhts again. I know I'm certainly not ready to be down again, I'm not even up again yet. This might very well end up on a back burner for a while, but I do need to know my options. I don't like "hanging in the balance" so to speak.

[liseux]

My friend was not down for months, she was definitely laying down for a few weeks and then taking it easy for about 6 weeks total. She also potty trained her 2 year old ( I thought this was nuts!) at the same time and still healed very well. Is Fairfax too far you? I think getting a good opinion on what you may want to do might help. My friend did wait almost 2 years to do it and she also spent a week in the hospital, which definitely gave her healing a head start.

[seeing_stars]

I didn't have any perenium tearing, but I did have an upward labial tear that was corrected by my gyn. I considered flying to California and having a plastic surgeon do the repair, but decided against it. I'd say google all you can and try to come up with an option based on the results. The surgery I had was called a "labial revision" or "labiaplasty" (for cosmetic reasons), but I know that a friend who had terrible perenium tearing was seeing a proctologist for her treatment. *hug*