Revision of Scar Tissue

Abnormal vaginal scarring is most commonly a result of poor healing after childbirth when tearing or stitching has occurred, this can result in painful intercourse or during normal activity. If the area becomes infected after childbirth, it can lead to delayed healing, scarring, and possibly pain.

Abnormal scarring is often present after childbirth, where tearing or stitching is involved, after inadequate suturing methods, or in cases of intense vaginal trauma during vigorous intercourse where ripping may have occurred. Symptoms may include:

  • Decreased sex drive; as a result of low self-confidence
  • Nervousness about intercourse, leading to dryness
  • Pain during sex
  • Abnormal tissue elasticity

After tearing has occurred, infection or continual distress can cause the tissues to heal incorrectly and cause abnormal scarring. This can be painful as the skin will be less flexible and may have joined together creating abnormal anatomy.

The factors that may increase a woman’s chance of developing abnormal scarring include:

  • Complications during delivery: Scar tissue may form in cases where the vagina tears during delivery or episiotomy is performed.
  • Infection: In the case of infection during the healing process, scarring is more likely to develop around the infected area.
  • Low oestrogen levels: In cases where only small amounts of oestrogen are present, e.g. during breastfeeding, the vagina can become thin and acidic. This decreases the tissues ability to heal properly and can cause painful spots in the vagina.

Abnormal scarring can cause complications, including:

  • Infection susceptibility: Infection can cause scarring, taking over the area and leaving it vulnerable to other infections and diseases.
  • Pain: Delayed or abnormal healing can lead to vaginal pain, which can effect daily activities, such as sitting or lifting.
  • Pain during sex: Scar tissue causes the skin to become inflexible and can make it difficult for the vagina to stretch during intercourse.

There are many treatments for abnormal scarring, including:

Antibiotics:

Used initially to reduce infection and inflammation. This can reduce the risk for scarring and problems early on.

CO2 Laser:

Where there are small areas of scarring, laser is used to vaporise abnormal tissue, allowing for appropriate healing.

Oestrogen/ Oestrogen cream:

Oestrogen levels after childbirth are often low, especially in cases where breast feeding is continuing. A low level of oestrogen leads to reduced blood flow and higher acidity in the vagina, this causes poor healing and discomfort. The addition of oestrogen will improve blood flow and nerve supply to the area, helping the healing process. This will also help with reducing the chance of repeated infection.

Excision and re suturing:

Using newer, biodegradable sutures (used in plastic surgery) can help the scarring return to normal. This is often the course taken when refashioning abnormal anatomy, as the vaginal folds may have healed in the wrong place.