Can perinealplasty effect anal sphincter tone or strength? How close does perinealplasty get to anal spincter?

I had 4th degree and want perinealplasty but scared to death of doing harm or effecting my spincter tone. I don't feel I am the ideal candidate due to 4th.

Doctor Answers 3

Will perineoplasty affect anal sphincter tone?

A well performed perineoplasty should improve your anal sphincter tone.  You will require evaluation by specialist rather than just a cosmetic surgeon.  The subspecialty in gynecology is FPMRS or Female Pelvic Medicine and Reconstructive Surgery.  A person with a fourth degree is actually the ideal candidate for surgical repair should this be required.  A FPMRS will also evaluate you for rectocele that likely will require repair at the same time.  Some FPMRS doctors - but not all - also focus on cosmesis and vaginal tightening.  This is the type of surgeon you should find.  Don't hesitate about getting a second opinion.  And don't assume that the doctor who delivered your baby will repair you the way you desire. 

Perineoplasty

Perineoplasty will not adversely sphincter tone. Aside from any cosmetic considerations regarding this procedure, there may be an additional benefit of lessening the likelihood of urinary tract infection (UTI).

Perineoplasty after 4th degree tear.

You need to be evaluated by either a cosmetic gynecologist or cosmetic urogynecologist. A perineoplasty or pelvic floor repair will in no way adversely affect sphincter tone and actually may strengthen it. Any qualified surgeon in the category mentioned above can evaluate your sphincter tone. A perineoplasty gets close but does NOT go into the anal sphincter, unless there is a reason to re-repair it.


best wishes,


Michael P Goodman, MD


Davis, CA, USA

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