QuestionQUESTION: I had an episiotomy during my labor 4 months ago. I found out a gap on the top of the episiotomy site. It looks like a cut, the tissue failed to fuse together. The gap is like 0.5mm long, it makes my vagina opening bigger. Also, I found some tissue (Scar tissue?) inside the vagina growing up to the top and it seems like trying to cover up the gap, but it won't because the gap (about 0.4 mm in depth) is separated tissue from it. I am guessing the top stitch came apart and cause the gap which makes me looks unattractive and this really bothers me.
Questions:
1. Do you the gap is a defect of episiotomy? Does it happen often?
2. Will the gap be fused by itself? The edges seem like completely healed.
3. If the gap never goes away, will it be a vulnerable place for me to tear when I vaginally deliver another baby?
4. My doctor didn't paid much attention on the gap, even it bothers me a lot; she doesn't want to restitch it since she thinks it will form star tissue and hence result possible intercourse pain. What do you think?
ANSWER: 1. Sometimes the tissue doesn't heal properly after an episiotomy. This usually has nothing to do with it being done incorrectly, but just that healing didn't happen the way in the way it should.
2. At this point, if the edges are healed, I would not expect it to fuse together. Your doctor would be able to give you a more accurate answer for your particular situation.
3. That's a good question. I would ask your doctor this one.
4. Because it bothers you a lot, then it's an important issue for you and I would strongly suggest that you talk to a second doctor. Ask if there are other options for repair other than re-stitching. A second doctor could also help answer questions #1-3.
I hope you are able to get this taken care of soon and that you are happy with the final results.
---------- FOLLOW-UP ----------
QUESTION: Thanks a lot for your answers. I actually got the second opinion, which is the same with my doctors. The second opinion says it doesn't impact on my sexual life, and it is an superficial gap and suggest to leave it as is. It seems like the second Dr. knows my doctor since she asked my Dr.'S name. I am wondering they are supporting each other and take it very cautiously. Should I pursue the third opinion? also, the second Dr. is very young with 5 years experience, it seems like she never saw this before.
AnswerSince you've already gotten a second opinion, I would suggest scheduling a consult with a midwife - she would be familiar with complications of episiotomy and might be more understanding of how this is affecting you emotionally and not just physically. She couldn't do any kind of surgery, but she might have some other suggestions for helping that area heal, and can certainly refer you for surgery if she feels would help. If you can't find a midwife in your area or would rather see a doctor, I would suggest finding a doctor who is not in your area that your other doctor doesn't know.
When you see the third person (doctor or midwife) I would make it very clear that even though this is not impacting your sexual life, that is IS impacting your life, because it bothers you alot, which should be evident by the fact that you are seeking help from a third person. Even if they suggest doing nothing, find out what your other options are. You can say something like, "I understand that you feel the best option would be to leave it alone. However, this makes me feel unattractive and it bothers me a lot - what are my other options?"
I wish you the best and I hope that you are able to get some answers.
