perineorrhaphy

[per″ĭ-ne-or´ah-fe]

suture of the perineum. The term is most often used to denote repair of an episiotomy done during childbirth, but it also can mean repair of any tear or laceration of the perineum.

Patient Care. Care of the wound and suture line is done as a clean rather than a sterile procedure. The wound should be kept clean and dry to avoid infection and promote healing. Most obstetrical patients prefer to do this for themselves if they are able; they must be taught how to do it correctly in order to avoid infection and trauma. They are told to work from front to back when removing soiled perineal pads and washing the site. The hands are washed before and after each cleansing as well as after urination, defecation, and replacement of a pad. Constipation and resultant straining at stool should be avoided as it can cause pain and injury to the suture line.

The suture line should be inspected periodically by the caregiver to be sure there is adequate healing of the suture line as well as a normal flow of lochia. Discomfort can be relieved by a cream or suture line spray and application of intermittent cold packs or ice for the first 24 hours, then applications of heat in the form of sitz baths, a heat lamp, or a rubber K-pad through which warm water circulates. Kegel's exercises also help relieve discomfort and promote healing by increasing circulation to and relieving edema of the operative site. If an analgesic cream or spray is prescribed the patient is taught how to apply it correctly.

To avoid discomfort while sitting, patients can be taught to squeeze the buttocks before being seated and to sit with them in that position. Perineorrhaphy sutures do not have to be removed because they are made of a material that is completely absorbed in about ten days. The discomfort associated with perineorrhaphy should subside in four or five days.

per·i·ne·or·rha·phy

(per'i-nē-ōr'ă-fē),

Suture of the perineum, performed in perineoplasty.

[perineum + G. rhaphē, a sewing]

Farlex Partner Medical Dictionary © Farlex 2012

perineorrhaphy

(pĕr′ə-nē-ôr′ə-fē)

Suture of the perineum.

per·i·ne·or·rha·phy

(per'i-nē-ōr'ă-fē)

Suture of the perineum, performed in perineoplasty.

[perineum + G. rhaphē, a sewing]

Medical Dictionary for the Health Professions and Nursing © Farlex 2012

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References in periodicals archive

Sexual function problems have no CPT or diagnostic codes, and insurance won't cover a posterior repair and perineorrhaphy for those reasons alone.

Rectocele-related sexual problems

(6) Perform levator plication and perineorrhaphy as a matter of routine.

(4) Perform distal levatoroplasty and extensive perineorrhaphy (described in the next section of the text).

Step by step: obliterating the vaginal canal to correct pelvic organ prolapse: very elderly age, comorbidity, and disinterest in maintaining sexual function make a woman an ideal candidate for having POP corrected by surgery to close the vaginal canal, detailed here

Given this issue, it is pertinent to revisit posterior colporrhaphy and perineorrhaphy for rectocele repair without mesh augmentation.

Through much of this time period, posterior colporrhaphy and perineorrhaphy have proven to be the gold standard.

Master class: revisiting symptomatic rectocele repair

Although 45560 does carry slightly more RVUs than 57250 (posterior colporrhaphy, repair of rectocele with or without perineorrhaphy), the physician work portion of the RVU total for both codes is now identical: 11.42.

Colporrhaphy? Do not code for posterior repair

When a perineorrhaphy is performed, the bulbocavernosus muscles must be identified and plicated in the midline with care so as not to narrow the introitus so significantly that coital activity would be impaired.

Master class: managing posterior vaginal wall prolapse

I also often perform a perineorrhaphy to repair the perineal body and help with vaginal support.

Pelvic organ prolapse repair with Prolift

Liu, if the patient does not undergo a full perineorrhaphy from the vaginal approach as the last part of the total operation, then that surgeon must be considered stupid.

Surgeons respond to pelvic reconstruction column

Perineorrhaphy is not performed with this procedure, therefore recovery time is shorter than with other types of prolapse repairs.

Repairing posthysterectomy vaginal vault prolapse: little data available

For the external anal sphincter, use 2-0 prolonged delayed sutures (such as PDS II or Maxon), she advised, noting that second-degree repair and perineorrhaphy may be necessary to reattach the rectovaginal septum to the perineal body, thus restoring normal anatomy.

Tips on obstetric anal sphincter laceration repair. (Evidence-Based Approach)

All patients also underwent modified perineorrhaphy, and those with intact uteri underwent vaginal hysterectomy.

Largest case series to date: Colpocleisis seen as effective for prolapse in elderly. (Gynecology)