Outcomes of revision perineoplasty for persistent postpartum dyspareunia.

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.