title: Outcomes of revision perineoplasty for persistent postpartum dyspareunia.
abstract: OBJECTIVE
  : To determine outcomes of revision perineoplasty for women with persistent pain and anatomic distortion of the perineum following obstetric perineal laceration repair.
  
  
  METHODS
  : A prospective cohort study of 9 women who underwent revision perineoplasty for persistent dyspareunia and perineal scarring was performed. Symptoms of perineal pain, coital activity, dyspareunia, impact on self-esteem, and vaginal scarring were compared. Statistical analysis was performed using paired t-tests.
  
  
  RESULTS
  : All women had anatomic distortion of the perineum prior to surgical revision. Postoperatively, no woman had persistent scarring or granulation tissue. There was a significant decline in perineal pain from 6.1 ± 2.89 to 0.5 ± 1.13 (P = 0.02) and 89% of subjects reported an increase in coital frequency and satisfaction (P = 0.0002). An improvement in self-esteem and lifestyle were reported by 77% and 89%, respectively.
  
  
  CONCLUSIONS
  : In women with dyspareunia and perineal defects following perineal laceration repair, early consideration should be made for revision perineoplasty as a significant impact is noted on sexual function and quality of life.
authors.affiliation: From the Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System, Richmond VA.
authors.forename: Ashley P
authors.initials: AP
authors.lastname: Woodward
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews