EPISIOTOMY

General Information

DEFINITION--Enlargement of the lower part of the vaginal opening.

BODY PARTS INVOLVED--Vagina; perineum.

REASONS FOR SURGERY--Usually performed during childbirth, just before the widest diameter of the baby's head passes through the outlet of the birth canal. This allows easier passage of the baby's head, decreases the likelihood of injury to the baby's head and prevents damage to the mother's vagina, bladder and rectum.

SURGICAL RISK INCREASES WITH--None expected.

What To Expect

WHO OPERATES--Obstetrician-gynecologist, family doctor or midwife.

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies.
• After surgery: Blood studies.

ANESTHESIA--Local anesthesia by injection.

DESCRIPTION OF OPERATION

• An incision is made in the perineum, just before the widest part of the baby's head is to be delivered. The size of the incision depends on how large an opening is required for the baby's head to pass through safely.
• The baby and placenta are delivered.
• The surgical area is repaired with sutures that will be absorbed by the body.

POSSIBLE COMPLICATIONS

• Excessive bleeding
• Surgical-wound infection.
• Inadvertent injury to sphincter or rectum.

AVERAGE HOSPITAL STAY--2 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 6 weeks for recovery from childbirth.

Postoperative Care

† Use ice packs made of gauze soaked in ice--cold witch hazel to relieve discomfort.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Avoid vigorous exercise for 6 weeks after surgery.
• Resume driving 10 days after returning home.
• Resume sexual relations when your doctor determines that healing is complete.

DIET---No special diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation or abdominal swelling.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.