Perineum and Pelvic Floor Repair Surgery

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Gynaecology
Perineum and Pelvic Floor Repair

Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is Perineum and Pelvic Floor Repair?

When a bad tear occurs during birth or there has been poor stitching, the area between the vagina and the rectum can look disfigured when healed. This can affect confidence and cause discomfort during intercourse.

In some cases, it can lead to weakness in the pelvic floor and lax muscles, presenting problems in urinary function and, in worst cases, can even cause incontinence.

The good news is that surgery can make a massive difference to the way you look and feel, restoring both the cosmetic appearance of the perineum as well as the muscle tone deep in the pelvic floor and vaginal muscles.

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Words from our clients:

"I was extremely satisfied with the care and treatment I received at the Cadogan Clinic. My surgeon was friendly and informative and explained the procedure fully. My procedure went very well and with the excellent care of the nursing staff, I made a speedy and full recovery. Would recommend to anyone."

Eva Berry

"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"

Scarlett Elliott

"The girls on the reception at the clinic were very pleasant and professional. The nurse who took out my stitches after my surgery was just lovely and took me through step by step what she was doing and she also recommended a great cream to use to help with healing."

Georgina Nolan

“I was treated with care and provided with thorough knowledge about the procedure I was undertaking. My surgeon was very methodical (a perfectionist) and I felt I received A class treatment."

Courtney O'Sullivan

"Outstanding experience from the first appointment to being discharged. Very professional, friendly and a fantastic outcome."

Gemma Stevenson

"Reception staff very welcoming and efficient. Both nurses who I dealt with were fantastic, and the whole team (anaesthetist, surgeon etc) were friendly but professional, and really put my mind at ease. That I was able to stay later than I perhaps needed after my surgery to fit in with my husbands schedule was greatly appreciated."

Emma Davies

Why do people have this treatment?

Pregnancy and childbirth, particularly a vaginal delivery, can have a huge impact on a woman’s body. Sometimes giving birth can lead to tearing of the perineum, which requires stitches to fix. If these stitches are not done well, or the area has healed poorly, the perineum may look or feel disfigured and you may experience pain or discomfort during sex. This can have a negative impact on your self-esteem and body confidence and may also have an adverse impact on your romantic and sexual relationships. Perineum repair will be required.

Another common problem following pregnancy and childbirth is pelvic organ prolapse, caused by weakened muscles and ligaments in the vagina. In pelvic organ prolapse, one or more of the organs situated in the pelvis, including the bowel, uterus or bladder, slip out of their normal position and bulge into the vagina. Although this is not life-threatening, pelvic organ prolapse can cause discomfort or you may notice a heavy or ‘dragging’ feeling around the genitals. Pelvic organ prolapse can cause discomfort or numbness during sex and problems with urination, such as stress incontinence, an increased urgency when you go to the toilet or problems emptying your bladder. Depending on the severity of the prolapse, you may see a bulge or lump coming out of your vagina, or there may be no visual evidence of the prolapse. Pelvic organ prolapse is also a side effect of the ageing process.

The effects of a pelvic prolapse can impact on your sexual and romantic relationships, your social life, self-confidence, self-esteem and overall mental wellbeing.

If you are experiencing any of these symptoms and they are impacting on your quality of life, then you should consider perineum and pelvic floor repair.

Who is suitable?

Cadogan Clinic considers individuals fit for perineum and pelvic floor repair if all of the following are true of them:

Physically and psychologically fit and healthy
Bothered by the appearance and/or function of their perineum and pelvic floor area
Have realistic expectations of what can be achieved by surgery

You may also be experiencing one or more of the following:

Pelvic organ prolapse (bladder, bowel, uterus, top of the vagina)
A loss of sexual function or sensation
Urinary incontinence
Pain during sex
Injury or trauma caused by childbirth

If you are planning another pregnancy, particularly with a vaginal birth, you may wish to consider waiting until you have completed your family. Perineum and pelvic floor repair will not make your body immune from the changes brought about by pregnancy and childbirth. If you go on to have another pregnancy after your surgery, this may affect the result and you may need to repeat the surgery at a later date.

Perineum and Pelvic Floor Repair
Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.

Our Surgeons

Mr. Yasser Diab

Gynaecologist and Obstetrician

What to expect

Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.

Find out more

01.Consultation

Your journey with the Cadogan Clinic will start with up to two consultations with one of our leading specialist plastic surgeons at our award-winning premises in Chelsea. These consultations will take between 30 and 60 minutes.

During your consultation, your surgeon will ask about your expectations for your perineum and pelvic floor repair and talk about what will happen during the procedure. They will also explain how the procedure will affect you and the recovery period.

It is important that you are open and honest about what you hope to achieve through surgery to help ensure the best possible result. Your surgeon will be happy to answer any questions you may have at this point. It may be a good idea to write your questions down before attending the consultation. Having established what you want from the surgery, and what is possible given your anatomy, several key measurements will be made and standard clinical photography will be taken. Your medical history will be discussed and a physical examination will be carried out.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed with your perineum and pelvic floor repair or not following a two week 'cooling off' period.

02.Leading up to the procedure

If you decide to go ahead with surgery, the next time you will return to the clinic is on the day of your perineum and pelvic floor repair. It is important that you prepare by taking the following measures ahead of surgery.

Stop smoking. Smoking can slow the healing process. If you smoke, your doctor will recommend that you stop smoking six weeks before surgery and during the recovery period. You should avoid smoking for at least 48 hours before your surgery.
Avoid taking certain medications. You should avoid taking aspirin, anti-inflammatory drugs and herbal supplements in the week ahead of your surgery. Taking these can increase bleeding.
Avoid alcohol. You should not drink any alcohol for 48 hours ahead of your surgery. This is because alcohol can hamper the healing process.
Arrange for help during recovery. Make plans for a friend or family member to drive you home after you leave the hospital and stay with you for at least the first night of your recovery at home.

In the six hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid which will be allowed up to two hours before you are admitted to the clinic. Clear fluids include still water, black coffee and black tea.

03.On the day

Your perineum and pelvic floor repair will take place at our award-winning clinic in Chelsea.

You will be given a general anaesthetic to put you to sleep for the operation. In some cases the surgeon may use a local anaesthetic and sedation if appropriate.

Once the anaesthetic has taken effect, the surgeon will go through the vagina and use stitches to reconstruct the perineum while tightening the surrounding muscles and tissues to lift and support the pelvic organs. The surgeon may also make repairs to the front and rear walls of your vagina. Cuts in the vaginal wall are closed with dissolvable stitches. This means you will not have to return to the clinic to have any sutures removed.

The length of the procedure depends on the extent of your prolapse. Perineum and pelvic floor repair is performed as a day case.

Following your perineum and pelvic floor repair, you will recover in our ambulatory recovery rooms. You may feel a little drowsy but this often wears off within a few hours. Once you are able to eat and drink, and our specialist nursing team are happy that your initial recovery is complete, you will be allowed to leave the clinic with a friend or family member.

04.Recovery

As this surgery involves a very delicate area of the body, you will likely experience some mild pain or discomfort in the aftermath of your surgery. It is common to experience lower back pain, discomfort when sitting down and to experience a feeling of fullness in your bowel. You may experience some vaginal bleeding or discharge in the days following your perineum and pelvic floor repair. This may last for up to two weeks.

You should avoid heavy lifting, such as shopping and young children, for two to four weeks following your perineum and pelvic floor repair. You should avoid sports for four weeks.

If your work is physically strenuous and involves a lot of heavy lifting, we recommend being signed off for four weeks. If your job involves light duties then you may feel ready to return within a week or two.

You should avoid driving for six weeks as performing an emergency stop may cause pain to the treatment area.

Our on-call nursing service is open 24/7 during your recovery period to help with any questions or queries that you may have.

It is important that you follow all the aftercare instructions issued by your doctor. Failure to do so may impact on your recovery and the final result.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

The Patient Journey. A breakdown of what you can expect on your journey with us

The Patient Journey

Frequently Asked Questions

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Do I need downtime after the perineum and pelvic floor surgery?

Following your surgery you may experience some mild discomfort and swelling but this will usually disappear completely one or two weeks. Many of our patients go back to work after one week but your surgeon will advise you to refrain from exercise, driving and sexual intercourse until full healing has taken place.

Is perineum and pelvic floor surgery painful?

Most of our patients opt to undergo this procedure under general anaesthetic so you will feel no pain. After your surgery, any pain or discomfort you may experience will be controlled with medication provided by your doctor and this will usually subside within a few days.

How much does perineum and pelvic floor surgery cost?

Prices begin at £6000 depending on your initial consultation with your expert cosmetic gynaecological surgeon.

How long does it take to recover after perineum/pelvic floor surgery?

It generally takes around four to six weeks to fully recover from perineum and pelvic floor repair.

You should aim to go on short walks after your surgery, gradually increasing the distance each day. Exercise, such as swimming and gentle cycling, can be resumed four weeks after surgery.

You will need to do special pelvic floor exercises at home to help you heal from your perineum and pelvic floor repair.

You can return to work within four weeks or sooner, depending on the type of work you do. You can start driving again six weeks after surgery. Sexual activity can be resumed within four to six weeks after surgery. If you are experiencing vaginal dryness, then vaginal lubricant may help.

It is important that you rest and allow yourself time to recover. You must follow all the after care instructions issued by your surgeon in order to achieve the best result and ensure a swift recovery.

What risks are associated with perineum and pelvic floor surgery?

Perineum and pelvic floor repair is a straightforward operation and many women go on to make a good recovery. However, there are some risks that you should be aware of. Complications of perineum and pelvic floor repair surgery include: injury to the uterus or bowel, perforation of the bladder or rectum or a recurrence of symptoms, which may require further treatment. All of these complications are rare.

Rarely, over tightening of the perineum may cause the entrance to the vagina to become tight, which may require you to use lubrication or vaginal dilators. Sometimes corrective surgery may be needed, but this is very rare.

Any type of operation also carries a risk of excessive bleeding, developing a blood clot in a vein,

infection or an allergic reaction to the anaesthetic. However the risk of any of these happening during your vaginoplasty is small.

Our expert surgeon will discuss all the risks with you and will be happy to answer any questions that you may have before you undergo your vaginal tightening surgery.

What is perineum and pelvic floor repair?

Perineum and Pelvic Floor Repair is a cosmetic surgery treatment to restore both the cosmetic appearance of the perineum as well as the muscle tone deep in the pelvic floor and vaginal muscles which may have been damaged during childbirths.

What is the perineal body?

The perineal body is a fibromuscular mass located at the centre of the perineum. This structure contains smooth muscle, skeletal muscle, and collagenous and elastic fibres.

The perineal body sits beneath the skin and muscle fibres from the perineum and pelvic floor are anchored to this body. Women and men both have a perineal body.

In women, the perineal body sits between the vagina and anus. Part of the function of the perineal body is to support the posterior part of the vaginal wall against prolapse. Therefore if the perineal body is torn, damaged or weak, this puts the woman at a higher risk of developing pelvic organ prolapse.

A state of the art, award winning clinic.

Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.

About Us

Best in Class Facilities

All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.

Our Clinic

A Strong Tradition of Innovation

We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.

Our History

At Home in Sloane Street, London

We are proud that our state of the art award-winning clinic is located in one of the best neighbourhoods in the country

Welcome to Sloane Street

Clinics Nationwide

We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.

Get in Touch

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One of our friendly staff will be delighted to help with your enquiry.

0207 901 8500

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Our Lead Patient Advisor is here to support with any queries you may have

Perineum and Pelvic Floor Repair

What is Perineum and Pelvic Floor Repair?

Why do people have this treatment?

Who is suitable?

Perineum and Pelvic Floor Repair
Surgeons

What to expect

Frequently Asked Questions

A state of the art, award winning clinic.

What are the risks?

Related Treatments

Related Reading

Perineum and Pelvic Floor Repair

What is Perineum and Pelvic Floor Repair?

Why do people have this treatment?

Who is suitable?

Perineum and Pelvic Floor RepairSurgeons

What to expect

Frequently Asked Questions

A state of the art, award winning clinic.

What are the risks?

Related Treatments

Related Reading

Perineum and Pelvic Floor Repair
Surgeons