PREGNANCY-BIRTH Messages for June, 2000: Re: Discomfort after Episiotomy DR BRAUN

Re: Discomfort after Episiotomy DR BRAUN

From: bethany (anonymous@obgyn.net)
Fri, 30 Jun 2000 16:51:14 -0500 (CDT)

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In reply to: R. Daniel Braun, MD: "Re: Discomfort after Episiotomy"

At Thu, 29 Jun 2000, R. Daniel Braun, MD wrote: >
>At Wed, 28 Jun 2000, Murt wrote:
>>
>>Perhaps someone could help with this query.
>>
>>I had a RML episiotomy due to forceps delivery 8 mths ago. However I
>>still have some vaginal discomfort at the vaginal outlet where I believe
>>the stich line was. My OB has said that the discomfort is caused by
>>normal vaginal tissue and is not scar tissue. She said there was
>>nothing she could do for me - the only way to cure the discomfort was to
>>have another baby and surgery was unecessary. Does this mean that I
>>just have to live with the discomfort?
>
>Most likely. This is one of the reasons that we quit doing mediolateral
>episiotomies 25 years ago. Now there is a resurgence of them because of
>the incidence of fecal incontinence following midlines that extend into
>the rectum. Having another baby may not make it go away either. There
>has to be some scar tissue there because that is how tissue heals, by
>forming scar.
>RDB
>

Dr Braun, I have also seen a resugence of this type but without dysparunia. Aside from short term pain (recovery) what would be the other drawbacks. I'm only talking very restricted use here. In your opinion should this procedure be an option for patients who you fear will have a 4th degree. I'm not sure ho long you have practiced but it would be nice to get an opinion on this from someone who has used both types.

> Should I seek another opinion?
>>
>>Is it possible to have a 'seam' where the stitch line is and thus new
>>tissue grows over the join? Or is it possible that the vagina can 'drop'
>>after a birth. It feels as if there is something constantly 'rubbing'
>>at the vaginal outlet and the perineum is too tight.
>>
>>Also, I have pain in my pelvic bone, like as if the bones are rubbing
>>together, when I do particular activities, like digging the garden. My
>>OB said I'm fine but I evidently am not - I didn't have this before my
>>baby.
>>
>>I'd really appreciate some input as both these things are causing me
>>some distress as it appears that there is no avenue open to me.
>>
>>Thanks so much.
>>
>>--
>>Murt
>>
>--
>R. Daniel Braun, MD FACOG FOG
>
>This is for educational purposes only, and is not intended to be replacement or substitute for consultation and examination by an appropriate medical professional. Due to time constraints, private e-mails cannot be answered.
>

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In reply to: R. Daniel Braun, MD: "Re: Discomfort after Episiotomy"

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