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Outcomes of revision perineoplasty for persistent postpartum dyspareunia
Ashley P Woodward1, Catherine A Matthews
1From the Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System, Richmond VA.
Objective:
: To determine outcomes of revision perineoplasty for women with persistent pain and anatomic distortion of the perineum following obstetric perineal laceration repair.
Methods:
: A prospective cohort study of 9 women who underwent revision perineoplasty for persistent dyspareunia and perineal scarring was performed. Symptoms of perineal pain, coital activity, dyspareunia, impact on self-esteem, and vaginal scarring were compared. Statistical analysis was performed using paired t-tests.
Results:
: All women had anatomic distortion of the perineum prior to surgical revision. Postoperatively, no woman had persistent scarring or granulation tissue. There was a significant decline in perineal pain from 6.1 ± 2.89 to 0.5 ± 1.13 (P = 0.02) and 89% of subjects reported an increase in coital frequency and satisfaction (P = 0.0002). An improvement in self-esteem and lifestyle were reported by 77% and 89%, respectively.
Conclusion:
: In women with dyspareunia and perineal defects following perineal laceration repair, early consideration should be made for revision perineoplasty as a significant impact is noted on sexual function and quality of life.
