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Episiotomy tears and their prevention - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Vaginal and Uterus Health
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   I often experience tearing at my previous episiotomy site during sex even when well lubricated. I had my second child 5 years ago. What can to be done to prevent this from happening?
Doctor :   hi
Doctor :   Dr
User :   Hi
User :   Any suggestions? Do I need to have my epistiotomy site reclosed?
Doctor :   in this case, probably the repair of the episiotomy has not occured properly
User :   Is this common?
Doctor :   it is very unusual that the site after episotomy bleeds even after 5 yrs post delivery
Doctor :   this is very uncommon
Doctor :   this indicates that the repair was substandard
User :   It mainly seems to happen if my husband isn't completely erect.
Doctor :   in that case, it should not bleed at all, a semierect penis is not strong enough to cause bleeding
Doctor :   are you sure that it is the esisiotomy site that bleeds ?
User :   It's not really bleeding so much as it feels like the skin split open in the perineum area.
Doctor :   or it could be a vaginal mucosal tear inside the vagina ?
Doctor :   is it seen on the surface ?
Doctor :   or inside the vaginal orifice ?
Doctor :   and how long have you had this problem ?
User :   It's right at the vaginal opening. I can't see it myself :)
User :   I've really only notice this problem in the last year or so.
Doctor :   ok
Doctor :   so it hurts while having intercourse , is this right ?
User :   Yes. but the pain is on teh surface. I can feel a groove where the skin split between by vaginal opening and anus.
Doctor :   this issue could be due to either no proper healing of the episiotomy , or due to erosions occuring due to rough sex
User :   Well I wouldn't say we have rough sex.
Doctor :   applying a steroid cream can reduce the inflammation and can aid healing
Doctor :   ok
User :   I've been using tucks pads on the area. I guess I would like to correct the problem so it doesn't happen rather than have to treat it afterwards.
Doctor :   You may have to avoid intercourse for a week or two for the site to heal properly
Doctor :   if time is not given for proper healing , it may continue to give problems
User :   Thanks fine. But we have sex fairly infrequently anyway and it happens pretty much every time.
Doctor :   if the problem persists and causes more issues, then the area needs to be surgically repaired , and this can be done via a office procedure by your gynae as well
Doctor :   it does not need a admission into the hospital
Doctor :   and once properly done, the area would completely heal within 2 weeks
User :   I mentioned this problem briefly at my last office visit and was told it was just one of the joys of getting older. I may need to change doctors.
Doctor :   and you will have no issues in the future
Doctor :   that is infact the wrong approach by the doctor
User :   I agree.
Doctor :   you can decide and take a second opinion
User :   Ok Doctor, thanks for your advice. I'll ask around and get a recommendation from my friends as to their GYNs.
Doctor :   sure
Doctor :   you are most welcome
User :   Bye
Doctor :   hope your issue gets solved soon
Doctor :   take care and bye for now
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