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Perineoplasty (also perineorrhaphy) denotes the plastic surgery procedures used to correct clinical conditions (damage, defect, deformity) of the vagina and the anus.〔Nichols DH, Clarke-Pearson DL. (2000) Gynecologic, Obstetric, and Related Surgery. 2nd Ed.〕〔Gilbert DA. (1999) Female Aesthetic Genital Surgery. Reconstructive and Plastic Surgery of the External Genitalia. Ehrich R, and G. Alter, Editors.〕〔Woodruff JD, Genadry R, Poliakoff S. (1981) Treatment of Dyspareunia and Vaginal Outlet Distortions by Perineoplasty. Obstetrics and Gynecology. 57:750–754.〕 Among the vagino-anal conditions resolved by perineoplasty are vaginal looseness, vaginal itching, damaged perineum, incontinence, genital warts, dyspareunia, intraoital stenosis, vaginismus, vulvar vestibulitis, and decreased sexual sensation. Depending upon the vagino-anal condition to be treated, there are two variants of the perineoplasty procedure: the first, to tighten the perineal muscles and the vagina; the second, to loosen the perineal muscles. ==Surgical correction== A perineoplasty procedure repairs damage to the perineum and damage to the Vulva that a woman might experience as a result of: * Child birth — the stretching of parturition can cause tears to the tissues, or might require cutting (episiotomy) should the woman’s birth canal prove too narrow to allow unobstructed passage of the infant.〔Nichols DH, Clarke-Pearson DL. (2000).〕〔Gilbert, DA. (1999).〕〔http://www.momaroo.com/684309515/inappropriate-vaginal-repairs〕 Moreover, any perineal tissue that presents either a cut or a tear can heal and fuse together before the stitches dissolve, regardless of whether or not the tissues originally were joined in that anatomic configuration. * Obesity — excess weight can over-stretch and damage the structures of the perineum, and can also stress and cause the separation of the perineal muscles.〔Gilbert DA. (1999)〕 * Inadequate innervation — either an absence of nerves or too few nerves.〔 * Sexual penetration ;Indications Clinically, the woman reports a feeling of physical looseness in her vulvo-vaginal area, which might be associated with decreased sexual satisfaction when compared to the degree of her sexual satisfaction before the incidence of the perineal damage. The indications can include detachment of the anal sphincter muscle, and the collapse of her rectum (rectocele). Perineoplasty is occasionally associated with posterior colporrhaphy, and can be performed in conjunction with the procedure.〔 A perineoplasty procedure first involves a V-shaped incision to the posterior wall of the vagina. Incisions atop the V-incision can be flat, curved, or angled upwards, which incision is applied is determined by the degree of vaginal tightening to be achieved.〔〔Gilbert DA. (1999).〕 Once the incision is made, any existing scar tissue and abnormal tissue fixations that resulted from previous injury or surgery or injury are removed. Depending upon the degree of damage occurred to the perineum, the corrections can include the: * Pubococcygeus muscles * Bulbospongiosus muscles * Other muscles detached from their perineal attachments Stitching of the muscles is carefully performed to avoid creating transverse ridges, and so produce a ridged interior surface in the vagina.〔Nichols DH, Clarke-Pearson DL. (2000)〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Perineoplasty」の詳細全文を読む スポンサード リンク
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