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ATTN DR. DAVID ASHLEY HILL from CONNIE -- episiotomy -- answers to your questionsFrom: Connie (anonymous@obgyn.net)Sun, 25 Oct 1998 12:31:34 -0600 (CST)
Dear Dr. David, Thank you for your comments. I will explain to you the situation regarding my episiotomy and hopefully you will be able to shed some answers regarding the problems I still have.
">should really have a thorough exam, looking for a fistula (hole
between
>the rectum and vagina)," Luckily I did not get a fistula from the episiotomy (although I discovered from other patients that had deliveries with the group I went to -- that fistulas and 4th degree lacerations were a common occurence -- HOW TERRIBLE!) The wall between my vagina and rectum is OK.
YOUR NEXT suspicion:
" scar tissue, or trigger points. Sometimes tiny
>nerves get jumbled up in scar tissue. Either injecting this area with a WELL -- let me explain this part of your Q: TRIGGER POINTS -- YES! right at the opening of the vagina. The skin is not symmetrical at the "V" let's say. When the doctor cut the episiotomy -- he did a MEDIAN cut -- BUT apparently the scissor did not cut the skin from let's say 12 o'clock to 6 o'clock STRAIGHT LINE down the vagina to anus. His scissor went from let's say 11 o'clock to 6 o'clock. When he sewed it back up -- right at the opening, the skin is overlapping and it hurts EVEN if I touch it with my finger. STILL. There was skin sewn up that was mucosa overlapping with external vaginal skin. REALLY SLOPPY JOB. 2 of the other OB's I saw around 4 months post-partum tried using TCA (Trichloroacetic Acid) to burn away skin that didn't belong there. (I was told that TCA is usually used to treat vaginal warts -- a condition luckily that I have never had). The OB's had tried to get rid of unwanted skin tissue by using the LONG Q-Tips with the silver nitrate ,but it had not worked. Now right at the opening, upon sexual intercourse -- the skin at that "V" spot gets a PAPER CUT effect, and it bleeds. And that really hurts. It leaves me with a very sore feeling, that lasts about 3 days. Sexual intercourse is very painful. The last time I had intercourse I had to pretend I wasn't hurting, and then I reached a point where I could no longer continue, and I had to stop. And it is 2 1/2 years after the fact. Let me also advise you that I was VERY sexually healthy and active prior to the episiotomy. Now -- the incision led to a 3rd degree tear --OUCH! but my sphincter is OK -- I have total bowel control. An additional problem I have is that the episiotomy site -- epsecially on the inside of the vagina (the mucosa part) the skin is TOTALLY BUMPY -- the whole area is so tightly sutured that I can compare it to when you sew a piece of fabric and the thread bunches it up together. Part of this bumpiness ends up at the opening. Let me tell you-- this has TOTALLY ruined my sex life. This problem lead to a MAJOR sexual frustration for my husband and he divorced me as you probably read in my first posting on this forum. How is the external skin and mucosa part of the skin supposed to feel after an episiotomy. Is this type of bunching up NORMAL AT ALL?????? I had been advised the following -- either I have an OB REDO the whole thing -- or wait till I have another baby to REDO it at that time. Personally, IF I ever have the great fortune of having another child -- I do not want anyone to cut me EVER AGAIN. Another problem I have is that with the force of the vacuum -- a part of the right wall of the inside of my vagina was apparently torn -- However, the suturing was done AGAIN -- TOO TIGHTLY (The doctor kept raving he was going to turn my vagina into a virginal state and that my husband would thank him -- YEAH RIGHT). As the suturing was done so tightly -- I have what several other OB's who I visited called a DEPRESSION MEANING A DENT. Like a car dent. On the right side inside. Now this dent really hurts still -- upon touch -- OR when it is HUMID or RAINING. WHY?????? Sometimes, depending on how I fold my legs while sitting -- I also feel pain at that DENT spot. Another thing I want to mention is that I also got a cervical tear from the delivery. The OB who delivered me did not write down ANY of the information regarding the traumas. But the OB's I visited AFTER him, saw it -- and then I went back to one who delivered me and he said OH YEAH !!!! Oh, there it is DUH??? I was told the cervical tear is at the OS at 2 o'clock. It has healed but the area there is NOT a circle. It looks like an ALMOST circle with an OPEN SCISSOR effect at 2 o'clock. Can you please explain this to me also? Can this affect a future pregnancy? Let me also make some comments about the OB who delivered me. When I had gone to his office to discuss why I had so much pain -- among one of the questions I asked him was what type of suturing material he had used. Now this part will make you laugh I am sure. He said he used "catgut." Now, I am not a doctor. And so, when I heard catgut -- I said WHAT!?? CATGUT??? I said, "is that made from the guts of cats??? I said did you have any idea that I am allergic to cats??" He said, "REALLY?" He said, "maybe the episiotomy didn't heal that well because I use catgut to repair them and well, I GUESS it's made from the gut of cats." Anyway, he used 2 different suturing materials. One that was light beige in color, and one that was kind of dark like blue/black. So you see, Dr. David, I really fell in the hands of a very unprofessional doctor. I anxiously await your professional opinion regarding these issues. THANK YOU and TAKE CARE.
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