In detail

Perineum rupture

Perineum rupture

Perineal rupture is a condition of the perineal area in women. It is characterized by the cracking of the local tissue and is caused by the weakening of the muscular-aponevrotic apparatus of the perineum. It often occurs in women who give birth vaginally and is the main cause of urinary incontinence or sexual discomfort in them. The sooner it is discovered, the less invasive the treatment may be, and Kegel exercises can be used to correct it.

What are the causes and risk factors for uterine rupture?

The perineum is the area that holds all the internal organs in the abdominal cavity. When the musculature and the perineal tissues become weak, as a result of exerting pressure on them (as in the vaginal birth) this crack appears in the perineal tissues. It is located between the posterior corner of the vulva and the anus. Therefore, natural birth is a frequent risk factor for the onset of this condition. It is important to know that the rupture does not necessarily occur immediately after birth. It can take years to trigger, even if the main cause remains the effort and pressure from vaginal birth. If you have also had an episiotomy at birth, the risk is even higher. Specialists also claim that women who are older or who are entering menopause are more likely to have a uterine rupture. The cause is explained by the decrease in the level of estrogen which has the role of maintaining firmness of the pelvic wall.

How is the perineal rupture manifested?

The most common manifestations of the condition are urinary incontinence (involuntary loss of urine) that occurs at the slightest physical exertion and discomfort during sexual intercourse. Sexual discomfort arises from widening of the vaginal canal. This has the effect of lack of sexual pleasure, decreased libido and, in some cases, can induce frigidity.

How is the diagnosis made?

At the first signs of urinary incontinence it is good to go to the doctor. The specialist who can diagnose is the gynecologist. It can detect the condition after a simple pelvic exam.

What complications can occur?

If not discovered and treated in time, the condition can develop and cause complications: genital prolapse (slipping of the uterus, bladder, rectum in the vagina); cystocele (bladder fall into the vagina); the urethrocellus (small size dilation of a segment of the urethra).

How is it treated?

There are several ways to treat this condition: drug; surgery; surgical + medicinal; through Kegel exercises. The sooner the perineal rupture is discovered, the easier and less invasive the treatment. If detected early, it can be corrected by performing special physical exercises, called Kegel. They have the role of strengthening and toning the pelvic floor muscles and to fight urinary incontinence. But they must be done after a strict program and over a longer period of time. It even takes a few months to see the first signs of recovery. But it remains a natural, non-invasive method of treating this condition and which involves no risk. In addition, they have the advantage of being able to be made anywhere, anytime.

The common treatment for correction of the perineal rupture remains the call for surgery. Some doctors recommend the surgical method from an early stage of cracking, even if there are other methods that can correct it, much less invasive. Surgery can be performed both vaginally and abdominally. It is performed under general anesthesia and aims to restore the perineum, vaginal wall, muscles and vaginal mucosa depending on the severity and evolution of the crack. Through surgery, doctors improve the aesthetics of the genital organs, and help narrow the vaginal canal to help improve the patient's sexual life. Medicinal treatment is often complementary to surgical intervention and in very few cases is considered the unique form of treatment. He usually has the role of helping postoperative recovery.

Tags Vaginal birth Kegel exercises Natural birth Birth pains Pregnancy disorders Postpartum urinary incontinence