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Episiotomy and tears: Treatment, symptoms, advice & help

About episiotomy and tears

Episiotomy is a surgical incision between the vagina and the anus, done in order to enlarge the vaginal opening. This surgical incision is usually needed during vaginal delivery. On the other hand, vaginal tears are spontaneous tears in the vaginal opening which may occur during childbirth.

Episiotomy and tears: Incidence, age and sex

Episiotomy is not a routine part of every childbirth but done on ‘as needed basis’. It is one of the commonest surgical procedures in childbirth but its rate has decreased in recent times. This procedure is more common in countries like India, Poland and Bulgaria. It is mainly indicated in cases where the baby is in abnormal position or is big for the date and vaginal tears are likely to occur.

Signs and symptoms of episiotomy and tears: Diagnosis

Both vaginal tears and episiotomy are a part of childbirth, in cases of vaginal delivery. Episiotomy is a surgical excision which is done under local anesthesia. A right medial-lateral incision is made in the perineum, extending from the vagina to the anus.

On the other hand vaginal tears are very painful and usually occur in the second stage of labour. The vaginal tears can be graded based upon the severity and extent of tear. For example, first degree tear is limited to vaginal and vulval skin only. But the fourth degree tear is extensive involving the anal sphincter and rectal skin also.

Causes and prevention of episiotomy and tears

Several causes are implicated for the procedure of episiotomy namely the presence of a big baby or baby in an abnormal position. It may also be done when one wants to speed up the second stage of labour. Moreover it is also considered in case when one is expecting the use of forceps in vaginal delivery. Inelastic perineal muscles also indicate for the need of episiotomy. Vaginal tears usually occur when the vaginal opening is not large enough for the baby to pass.

Episiotomy and tears: Complications

Episiotomy and vaginal tears is some cases may get infected and result in fever and localised pain. The affected individuals may also complain of pain during sexual intercourse even weeks after the procedure.

Episiotomy and tears: Treatment

The episiotomy can be repaired under local anesthesia and absorbable synthetic sutures are used for its repair. The same surgical repair may be done in case of vaginal tears. Adequate rest is needed for healing of tears and episiotomy repair. A good and adequate perineal hygiene is essential in proper healing of the episiotomy.