eMedicine Specialties > Obstetrics and Gynecology > Gynecologic Surgery
Vulvar-Vaginal Reconstruction: Follow-up
Updated: Aug 20, 2007
Outcome and Prognosis
In the absence of early infection and wound breakdown, perineal trauma generally responds favorably to surgical therapy. Posttraumatic chronic pain is possible.
Two sites are at increased risk of long-term functional deficit: the urethra and the rectal sphincter. A progressive decrement in function of both of these structures occurs with aging. Many women experience additional decrement associated with sphincter repair, especially of the external anal sphincter.
As noted, the ultimate cosmetic result following acute management of perineal trauma may be suboptimal. Plastic revision may be considered after completion of the healing process but generally should be delayed 3-6 months.
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| Workup: Vulvar-Vaginal Reconstruction |
| Treatment: Vulvar-Vaginal Reconstruction |
Follow-up: Vulvar-Vaginal Reconstruction |
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References
Propst AM, Thorp JM Jr. Traumatic vulvar hematomas: conservative versus surgical management. South Med J. Feb 1998;91(2):144-6. [Medline].
Gianini GD, Method MW, Christman JE. Traumatic vulvar hematomas. Assessing and treating nonobstetric patients. Postgrad Med. Mar 1991;89(4):115-8. [Medline].
Bachoo P, Brazzelli M, Grant A. Surgery for faecal incontinence in adults. Cochrane Database Syst Rev. 2000;(2):CD001757. [Medline].
DeLancey JOL. Surgical Anatomy of the Female Pelvis. TeLinde's Operative Gynecology. 1997;63-93.
Goldman HB, Idom CB, Dmochowski RR. Traumatic injuries of the female external genitalia and their association with urological injuries. J Urol. Mar 1998;159(3):956-9. [Medline].
Grant JCB. An Atlas of Anatomy, Williams and Wilkins. 1972;225.
Grisoni ER, Hahn E, Marsh E, et al. Pediatric perineal impalement injuries. J Pediatr Surg. May 2000;35(5):702-4. [Medline].
Netter FH. The CIBA Collection of Medical Illustrations. 1965;2:90-104.
Rab M, Ebmer And J, Dellon AL. Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain. Plast Reconstr Surg. Nov 2001;108(6):1618-23. [Medline].
Further Reading
Keywords
vulvar-vaginal reconstruction, perineum, perineal trauma, perineal dysfunction, sexual abuse, parturition, birth canal, vaginal introitus, acute deceleration injury, straddle injury, insertion injury, forceful coitus, intrapartum laceration, obstetric trauma, sexually transmitted diseases, STDs
Follow-up: Vulvar-Vaginal Reconstruction