Urogenital Surgeries - Female
• Perineal body reconstruction (Episioplasty)
• Urethroplasty
• 3o Rectovaginal tear repair
• Rectovaginal fistula repair
Perineal Body Reconstruction (Episioplasty)
Indication
• Pneumovagina or persistent endometritis following Caslick's procedure
Equipment
• No special equipment is required.
Preparation
• Sterile saline is used instead of alcohol to remove antiseptic soaps, because alcohol may cause excessive perineum
irritation
Procedure
• Vulvar retraction
• Triangular areas of mucosa are removed from the perineal body
• The resultant exposed submucosa forms a right-angled triangle
• Closure of the ventral vestibular mucosal margins is performed cranial to caudal
• Caslick's procedure is performed to appose the vulvar opening
Expected Outcome
• Adequate reconstruction alleviates pneumovagina in most cases
• Occasionally, pneumovagina does not resolve following Caslick's procedure or perineal body reconstruction
• In these cases, perineal body transection may be warranted
Complications
• Minimal
• Dehiscence
• Suture sinus tract development
• Excessive ventral closure may result in urovagina
