Perineoplasty (perineorrhaphy) repairs the perineum, the area of skin and muscle between the vaginal opening and the anus. It removes scar tissue, often from a tear or episiotomy that healed badly, and brings the separated perineal muscles back together to rebuild the perineal body and narrow a gaping vaginal entrance.
It can relieve pain from scarring, a feeling of openness, trapped air or water, and an altered appearance after childbirth. It can also be done in reverse, to release an entrance left too tight by a previous repair. It addresses the entrance only. It does not tighten the vaginal canal, lift a prolapsed bladder or rectum, or cure incontinence, though it is often combined with operations that do.
What Perineoplasty involves
Examination establishes what is actually wrong: the thickness of the perineal body, scar bands, muscle separation, any prolapse of the back or front vaginal wall, and the state of the anal sphincter, with endoanal ultrasound if there are bowel symptoms. With you under anaesthetic, a diamond or triangular area is marked, with its apex inside the back wall of the vagina and its base on the perineal skin. The scarred skin and vaginal lining within it are removed. The surgeon finds the ends of the bulbocavernosus and transverse perineal muscles, which have pulled apart to the sides, and stitches them together in the midline in layers with dissolving sutures. The vaginal lining and the skin are then closed. When the aim is to relieve tightness, the scar is instead cut lengthways and closed crossways, or a small flap is advanced, to widen the opening.
Who is a good candidate for Perineoplasty?
It suits women whose symptoms clearly come from the perineum and who have finished having children.
- Painful, puckered or asymmetric scarring after an episiotomy or tear
- A widened vaginal entrance with reduced sensation for either partner, trapped air or water
- A thin, deficient perineal body after childbirth, sometimes with difficulty emptying the bowel
- Pain on penetration from a repair that left the entrance too narrow
- As part of posterior repair for rectocele
It is usually not the right choice if:
- Women planning a vaginal birth, which would probably undo the repair
- Within 6 months of delivery or while breastfeeding heavily, since tissues are still recovering and low in oestrogen
- Pain during sex caused by vaginismus, vulvodynia, dryness or pelvic floor spasm, which surgery can worsen; these need physiotherapy and medical treatment
- Laxity felt deeper in the vagina or symptoms of prolapse or leakage, which need a different or additional operation
- Active infection or untreated skin conditions such as lichen sclerosus
Technique options
- Classic perineoplasty with muscle approximation: For a gaping entrance and deficient perineal body.
- Scar revision or Fenton's procedure: Widens an entrance left too tight and excises painful scar.
- Combined with posterior colporrhaphy: When the back wall of the vagina bulges (rectocele).
- Combined with anal sphincter repair: For old third or fourth degree tears with bowel control problems, done with a colorectal or urogynaecology specialist.
- Pelvic floor physiotherapy: First-line for mild laxity and essential after surgery; laser and radiofrequency devices have limited evidence for this problem.
What happens during your treatment
The operation takes 45 to 60 minutes under local anaesthetic with sedation, spinal or general anaesthetic, as a day case. The area feels bruised, swollen and tight afterwards. Sitting is uncomfortable for the first week; a soft or ring cushion helps.
Preparing for your trip
Plan for 6 to 8 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.
- Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
- Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
- Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
- Book a changeable return flight; your surgeon confirms when you are fit to fly
Recovery and results
Keep the area clean and dry, rinse after using the toilet, and use ice packs for the first 48 hours. Stool softeners for 2 to 3 weeks prevent straining on the repair. Most women return to desk work after 1 week. Avoid intercourse, tampons, swimming, cycling and heavy lifting for 6 weeks. Stitches dissolve over 2 to 4 weeks and can itch. Once healed, vaginal oestrogen, perineal massage, dilators or physiotherapy may be advised to keep the scar supple. Flying home after 5 to 7 days is usually fine.
- Back to everyday activity: 1 week, no sex for 6 weeks
- When results show: Healed at 6 weeks, scar softens over 3 to 6 months
- How long they last: Long lasting unless followed by vaginal birth
Safety, risks and revision policy
Healing is generally good, but this is a sensitive area and over-tightening is the mistake to avoid.
- Pain during intercourse from a repair that is too tight or from a tender scar, the most important risk
- Wound breakdown or infection, since the area is moist and close to the bowel
- Bleeding or haematoma
- Persistent symptoms if the cause lay deeper than the perineum
- Altered sensation
- Rarely, injury to the rectum or a fistula
- Recurrence after a later vaginal delivery
Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.
Cost of Perineoplasty in Türkiye
Clinic-Y does not publish a single price for Perineoplasty, because the honest figure depends on your case. What moves it:
- Perineoplasty alone versus combined prolapse or sphincter repair
- Type of anaesthesia
- Surgeon's specialist training in urogynaecology
- Hospital stay, if combined surgery requires it
- Pelvic floor physiotherapy afterwards
Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.
Frequently Asked Questions
Is perineoplasty the same as vaginoplasty?
No. Perineoplasty repairs the entrance and the tissue between vagina and anus. Vaginal tightening procedures work on the canal further in. They are often combined.
Will it improve sex?
If the problem is scar pain or a gaping entrance, most women report improvement. If pain has another cause, surgery may not help, so an accurate diagnosis matters.
Can I have a baby afterwards?
You can, but vaginal delivery may tear the repair. Many obstetricians would discuss a planned caesarean. It is better to wait until your family is complete.