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Traumatic disruption of perineum is quite common in women. Parturition is often associated with risk factors. Moreover participation in physical activities like sports causes injury and heighten the risk factors. In most of the cases self care may help in healing the injury but if the disruption of tissue takes place at deeper level and affects vascular anatomy, then such cases need to be treated with surgery. The surgical treatments conducted for tissue disruption is referred to as Vulvar-Vaginal Reconstruction.
Trauma in female perineum can take place due to various reasons. When the fetus passes through the vaginal tract during delivery, then it may cause disruption. Such disruptions are also caused by usage of forceps and other clinical instruments. Deceleration injury which is often caused by falling on crossbars of cycle can result in trauma. Injury due to sudden fall or insertion of foreign particles may also result in trauma.
Vulvar-Vaginal Reconstruction Treatment
Patients undergoing Vulvar-Vaginal Reconstruction have to go through medical therapy and in certain cases surgical treatment is necessary.
Persons suffering from prolong perineal trauma are devised to undergo a medical therapy for getting relief from acute pain and reduction of loss of blood. Besides, such therapy helps in the detection and treatment of injury in the pelvic regions and associated structures. Cosmetic restoration, though a secondary objective, is also one of the major aims of medical therapy for Vulvar-Vaginal Reconstruction.
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There may be trivial perineal trauma which is cured by conservative management. Injuries which takes place as a result of hemorrhage of body organs are also subjected to surgical treatments. If there is soft tissue disruption then palliative treatment is recommended which involves application of ice on the injury for at least 24 hours.
During surgical treatments of Vulvar-Vaginal Reconstruction, care must be taken in the pre operative and inter operative phase. As for pre operative stage, emphasis is given on the site of operation, anesthesia and medications in this stage.
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| In the interoperative stage, the surgery is conducted keeping in mind the reason behind the trauma. In case of straddle injury, first the perineum and vagina is examined to find out the extent of injury. If the disruption takes place only in the superficial epithelium with restricted bleeding, then oral analgesia and proper cleansing is enough.Perineal tissues are usually very elastic and prevents expansion of hematoma. Conservative management, application of ice packs and external pressure are usually suggested for Vulvar-Vaginal Reconstruction.
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