Postpartum Vaginal Adhesion Following Episiotomy: Treatment With Tampon Therapy

Postpartum vaginal agglutination/stenosis is a rare complication. It can lead to significant morbidity related to quality of life and sexual functioning. Documentation in the literature is limited, especially in low-resource settings. We present a case of complete vaginal stenosis in a 23-year-old primigravida homemaker from Udaipur, India, after a difficult episiotomy repair. The woman presented three months postpartum with dyspareunia and was found to have complete vaginal stenosis approximately 3 cm from the introitus on examination. The patient improved completely with conservative management consisting of sequential vaginal dilation with progressively larger tampons (10-15 mm), with complete resolution within two months and the resumption of intercourse without complication. This case emphasizes the necessity for timely follow-up of postpartum women to avoid, timely diagnose, and manage complications. The case demonstrates that tampon therapy is a novel, cost-effective, patient-centered, minimally invasive alternative to surgical adhesiolysis in the case of postpartum vaginal stenosis.