QuestionQUESTION: My wife had our son a little over four months ago and she's had a difficult recovery. For several weeks after she had perineal pain that seemed "deep" to the torn area (level 2 tear) Her ob told her she had some granulation tissue and treated it with Silver Nitrate. A few weeks past and it got a little better but it seems like she has pain more often than not. She says it's a crampy, soreness that is usually only present when standing, but in the past few days it's gotten so bad that she is having pain when lying down or sitting. It seems like running a short distance in the rain set it off this time. I read about some pubic symphisis issues, but I also wonder if its scar tissue in the musculature down there or granulation tissue inside. Can you offer any advice?
ANSWER: Pubic Symphasis Dysfunction usually causes extreme weakness, usually in one leg, sometimes both, and pain while walking, and would most likely cause your wife to limp or walk tilted over to one side. Extreme lower back pain may also be present.
Since you wife had a perineum tear, it sounds like this is not healing properly, or possibly that she has developed uterine or bladder prolapse. Prolapse would explain why it was triggered from running, and why it's mostly present while standing.
But the pain could also be due to adhesions, scar tissues which form around wounds/incisions. Adhesions can bind separate tissues together, prevent the normal small movements of internal organs, which in turn causes pain.
Certainly your wife needs an accurate medical diagnosis to discover the the root cause of her pain, and then she should receive appropriate treatment.
For more info on post-childbirth adhesions, consult the book "Ending Female Pain" at www.endingfemalepain.com. (In case you're wondering, have no association with the author or web site.)
---------- FOLLOW-UP ----------
QUESTION: How easy or difficult are these conditions to diagnose? Can they be fixed with only surgery? If so, how invasive is it and how is the recovery?
AnswerPubic Symphasis Dysfunction: Easy to diagnose, Physical Therapy is used to reduce or eliminate symptoms. Most make a full recovery.
Prolapse: Easy to diagnose. Treatment consists of exercise, use of a pessary, or in more extreme cases, surgery to lift organs back into proper positioning.
Incomplete healing of perineum tear: Somewhat difficult to diagnose, especially if done by your original OBGYN who might have improperly stitched the area, or missed a deeper internal tear.
Adhesions: Difficult to diagnose. Many OBGYN's have not been properly trained about the condition, or treatment. Deep tissue massage is used to break up adhesions. This should only be done by someone who specializes in this area of women's health.
