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Comparison of Degrees of Perineal Edema between the Group Treated with Hyaluronidase Injections and the Control Group
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Purpose:
Hyaluronidase (HAase) has many uses in medicine, and reports suggest that it affects perineal tissue during fetal passage through the vaginal canal. However, its potential use for preventing perineal trauma has yet to be determined. This study sought to evaluate the efficacy and safety of perineal HAase injections in reducing perineal tra...
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Most women who are primigravida are mostly confronted with episiotomy during child-birth to prevent the perineal and vaginal lacerations which could be performed at birth. There are many types of episiotomies which are median, mediolateral and J-shaped episiotomy. In here, we performed the mediolateral suture due to its safety. All episiotomy were...
Perineal lacerations affect between 35 and 85% of women during childbirth and may be responsible for postpartum pain. Honey has been demonstrated to have interesting properties that can promote wound healing. The aim was to evaluate the effectiveness of the application of honey to the perineum to reduce perineal pain during the early postpartum per...
Childbirth is a physiological process and an important event in life that is often remembered by a woman throughout her life, where birth trauma most often occurs is the perineum. A perineal tear is a perineal laceration that occurs when the baby is born either naturally or through an episiotomy. This study aims to determine the relationship betwee...
Citations
... Kindberg et al. [33] and Skilnand et al. [34] indicated in their studies that acupuncture can be used to reduce perineal pain, but local analgesics are more effective than acupuncture. Moreover, Kwon et al. [35] found that hyaluronidase can significantly reduce perineal edema and prevent perineal trauma. Ducarme et al. [36] asserted the effectiveness of perineal support in reducing the risk of perineal injury in the first or second stage of vaginal birth. ...
Background: Approximately 85% of women will experience perineal trauma during vaginal birth. Pain is one of the most important longterm complications of perineal trauma. The quality of life is negatively affected, the pain experienced is a cause of negative prejudice against future vaginal birth. Platelet rich plasma treatment is a new approach to treating the pain and healing perineal trauma. Case presentation: A 31-year-old female patient presented to the Gynaecology department with pain during urination, defecation, in coitus, during menstruation, while walking and while sitting. The pain continued to increase 10 years after the first birth and analgesic medications were ineffective. After gynacological examination, a diagnosis was made of perineal trauma (second degree) due to deep episiotomy in the first vaginal birth. The patient received three platelet rich plasma treatments at three-week intervals. Repeated assessments showed noticeable reduction in pain and improvements in scar healing. Conclusions: Perineal trauma was treated with platelet rich plasma containing high platelet concentrations and various growth factors. The patient's intense pain complaints ended.
Another operation in AGS that is performed, especially in combination with vaginoplasty operations, is perineoplasty, that is, aesthetic repair and/or reconstruction of the perineum. Different techniques and tips-and-tricks in perineoplasty are described in this chapter.
Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.
