A perineoplasty is an umbrella term used to describe several different surgical procedures that treat conditions of the vagina or anus. For many patients, a perineoplasty is done as a cosmetic surgery to restore the physical appearance of the vagina. Sometimes called a perineorrhaphy, perineoplasty has also been known to address issues of sexual dysfunction and enhance feelings of sexual pleasure.
The most common type of perineoplasty is conducted for purposes of perineum restoration. The perineum area between the vagina and the rectum, as well as the vagina itself, may become damaged due to childbirth, weight gain, or nerve problems. A perineoplasty for this purpose involves a tightening of the skin around the perineum, the removal of excess skin, and a close stitching-together of the essential muscles. Many women also have a vaginal surgery called a vaginoplasty around the same time; this process tightens the vaginal muscles and eliminates unneeded skin.
A perineoplasty can also be performed to treat issues relating to painful sexual intercourse or involuntary contractions of the vaginal muscles. This process is essentially the opposite of a vaginoplasty; the entry of the vagina is surgically loosened. Genital warts can also be removed through this type of perineoplasty.
Most perineoplasty surgeries are conducted under general anesthesia. Typically, patients are only in the hospital for the day and are not required to stay overnight. General recovery time is four to six weeks.
After perineoplasty, a patient may be advised to do pelvic exercises to aid the healing process. A patient is commonly encouraged to avoid sexual intercourse for the initial duration of healing, at least four weeks. Other recommendations might include refraining from heavy lifting, using pads — not tampons — to help control any normal discharge, and waiting at least one week before returning to work.
As with any surgery, perineoplasty has risks, though the procedures are considered exceptionally safe and effective. Infection and unusually heavy bleeding are among the most serious risks of the surgeries. If one of these conditions should develop, they can usually be treated easily.
Some types of perineoplasty are available as laser surgeries; perineum restoration, for example, can be done via laser technology. The outcome of the surgery is the same — a tightening of the muscles in the region — but the process utilizes lasers and requires no incision. A typical laser perineoplasty is done in a single 45-minute treatment. Recovery times and precautions generally remain the same as with more traditional approaches.