A perineal tear is a tear or injury to the skin and/or muscles between the vaginal introitus and the anal opening. The most common setting for a perineal tear is during childbirth. After such incident (especially if perineal tear was severe) there is often a challenge with following pregnancies when deciding on the optimal mode of delivery. Types of perineal tears Perineal tears are of different types depending on their extent and severity. They are classified as first, second, third and fourth degree. First degree perineal tears are known to affect only the thinned skin between the vaginal introitus and the anus. In at least half of the women with such an injury, no surgical repair is offered or accepted because there is no significant …show more content…
However, they may hasten short-term recovery. The degree of pain is not affected by the presence of sutures; therefore, it is not mandatory that all perineal tears of the first or second degree be repaired. An episiotomy repair does not require the baby to be kept away from the mother. It is usually performed using biodegradable sutures under local anesthesia, unless the woman is already using epidural anesthesia. Following repair, a few precautions are necessary to promote rapid healing and to prevent infection. The sutures usually dissolve within a couple of weeks at most. Increasing pain, a serosanguineous or purulent discharge, and a foul odor may all signal infection and should be reported to the healthcare provider promptly. The patient should take adequate fiber and fluids in her diet to avoid constipation. In case the tear involves the anal sphincter, the use of laxatives for a specified period may help avert a natural hesitation to pass feces and ensure that stool hardening does not develop. Furthermore, the use of a sitz bath is useful in many patients to alleviate perineal pain, provided clean and tolerably hot water is