Perineoplasty grade I–II (minimal perineal reconstruction)

Grade I–II perineoplasty is a minimally invasive gynecological surgical procedure aimed at correcting anatomical and functional changes of the perineum (the area between the vagina and anus), most commonly occurring after vaginal childbirth, episiotomy, or local trauma.

Grade I perineoplasty is indicated in cases of mild weakness of the perineal muscles and connective tissue structures, superficial scar changes, and minimal deformation of the vaginal introitus, without significant impairment of anatomical support.

Grade II perineoplasty is performed in cases of moderate perineal insufficiency, partial separation of perineal muscles, more pronounced scar tissue changes, and enlargement of the vaginal introitus diameter, accompanied by functional discomfort and reduced quality of intimate life.

Indications

• Mild to moderate perineal weakness (laxity)
• Superficial perineal injuries in the postpartum period
• Scar tissue changes following trauma or episiotomy
• Local discomfort, sensation of vaginal widening
• Decreased sexual satisfaction associated with perineal changes

Procedure and duration

The surgery is performed in an operating room under local or general anesthesia, depending on medical indications and patient preference. The procedure includes:

• controlled perineal incision;
• excision of excess or scar-altered tissue;
• reconstruction and re-approximation of the perineal muscles;
• layered suturing to restore proper anatomical structure.

The average duration of the procedure is 30–60 minutes. Perineoplasty may be performed as a standalone intervention or combined with other gynecological procedures, such as posterior colporrhaphy.

Contraindications

• Active genital or perineal infections
• Acute inflammatory conditions
• Uncontrolled coagulation disorders
• Pregnancy
• Severe systemic conditions contraindicating surgical intervention

Rehabilitation and limitations

• Local swelling and moderate discomfort may occur in the first postoperative days
• Relative rest and careful local hygiene are recommended
• Return to professional activity is usually possible after 7–14 days
• Sexual activity and intense physical exercise are contraindicated for approximately 6 weeks
• Full recovery typically occurs within 6–8 weeks (individual variation)

Advantages

• Restoration of perineal support and anatomical stability
• Reduction of the vaginal introitus diameter
• Improved functional comfort and aesthetic appearance
• Potential improvement in sexual satisfaction
• Minimally invasive procedure with relatively rapid recovery
   

Sources:

https://www.mdpi.com/2077-0383/13/24/7536?utm_source=chatgpt.com
https://pubmed.ncbi.nlm.nih.gov/22453161/
https://link.springer.com/book/10.1007/978-3-030-97691-0?utm_source=chatgpt.com