Treatment of vaginal scarring/pain

This is most commonly as a result of poor healing after childbirth, when tearing or stitching has occurred.  Sometimes an infection in the area after childbirth can lead to delayed healing and subsequent pain.

TREATMENT

If antibiotics and lubricants have not improved the discomfort or appearance, then surgical treatment is the best option, once the healing has settled down and the area is stable.  It is best not to do this within three to six months of childbirth unless there is an obvious infection or stitch abscess.

SURGICAL TREAMENTS

• Excision and resuturing with one of the newer, biodegradable sutures frequently used in plastic surgery, can be very successful.
• Surgical excision is often the answer, where refashioning of an abnormal anatomy is required, where the vaginal folds have healed in the wrong place.
• Lasering is useful where there are small areas of scarring as it vaporises abnormal tissue allowing appropriate healing. This will benefit scarring and abnormal tightening only but will not allow reconfiguration of an abnormal anatomy.
• Combination of Laser and Surgical excision/refashioning. Often this is required in more severe cases.

OTHER TREATMENTS

Antibiotics (see above):

- Used initially to reduce infection and inflammation.

Oestrogen/Oestrogen Cream:

- After childbirth oestrogen levels are often low, especially where breast-feeding is continuing.

- A low level of oestrogen in the circulation leads to poor blood flow; changes in the acidity of the vagina and poor healing. Use of topical oestrogen cream and pessaries, can improve blood flow and nerve supply to that area which will help with healing, whether or not surgery or laser has been advised.

- Local oestrogen will also reduce the chance of repeated infections by improving the amount of lactobacillus (good bacteria) in the vagina and correcting the pH avoiding recurrent overgrowth organisms.