eMedicine Specialties > Obstetrics and Gynecology > Gynecologic Surgery

Vulvar-Vaginal Reconstruction: Follow-up

Author: Stephen A Metz, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Tufts University School of Medicine; Adjunct Associate Professor, School of Public Health Sciences, University of Massachusetts; Consulting Staff, Baystate Medical Center; Private Practice, Division of Surgery, Hampden County Physician Associates
Contributor Information and Disclosures

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.

 


More on Vulvar-Vaginal Reconstruction

Overview: Vulvar-Vaginal Reconstruction
Workup: Vulvar-Vaginal Reconstruction
Treatment: Vulvar-Vaginal Reconstruction
Follow-up: Vulvar-Vaginal Reconstruction
Multimedia: Vulvar-Vaginal Reconstruction
References

References

  1. Propst AM, Thorp JM Jr. Traumatic vulvar hematomas: conservative versus surgical management. South Med J. Feb 1998;91(2):144-6. [Medline].

  2. Gianini GD, Method MW, Christman JE. Traumatic vulvar hematomas. Assessing and treating nonobstetric patients. Postgrad Med. Mar 1991;89(4):115-8. [Medline].

  3. Bachoo P, Brazzelli M, Grant A. Surgery for faecal incontinence in adults. Cochrane Database Syst Rev. 2000;(2):CD001757. [Medline].

  4. DeLancey JOL. Surgical Anatomy of the Female Pelvis. TeLinde's Operative Gynecology. 1997;63-93.

  5. 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].

  6. Grant JCB. An Atlas of Anatomy, Williams and Wilkins. 1972;225.

  7. Grisoni ER, Hahn E, Marsh E, et al. Pediatric perineal impalement injuries. J Pediatr Surg. May 2000;35(5):702-4. [Medline].

  8. Netter FH. The CIBA Collection of Medical Illustrations. 1965;2:90-104.

  9. 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

Contributor Information and Disclosures

Author

Stephen A Metz, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Tufts University School of Medicine; Adjunct Associate Professor, School of Public Health Sciences, University of Massachusetts; Consulting Staff, Baystate Medical Center; Private Practice, Division of Surgery, Hampden County Physician Associates
Stephen A Metz, MD, PhD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Colposcopy and Cervical Pathology, American Urogynecologic Society, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey B Garris, MD, Chief, Assistant Professor, Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Tulane University School of Medicine
Jeffrey B Garris, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American Medical Association, American Urological Association, Association of Professors of Gynecology and Obstetrics, Louisiana State Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Gail F Whitman-Elia, MD, Professor, Department of Obstetrics and Gynecology, University of South Carolina School of Medicine
Gail F Whitman-Elia, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Clinical Endocrinologists, American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American Medical Association, American Medical Women's Association, American Public Health Association, American Society for Reproductive Medicine, Endocrine Society, and South Carolina Medical Association
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

Michel E Rivlin, MD, Professor, Coordinator of Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine
Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh
Disclosure: Nothing to disclose.

 
 
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