After a 3rd degree tear you perineum and anus will be very tender. This can make it difficult to pass a stool.
Going to the toilet after a perineal tear
Whether or not you sustained a 3rd degree tear, a vaginal delivery will make the peri-anal region extremely sore in the weeks, or even months, after the birth.
This can create particular discomfort while passing a stool. Furthermore, any straining can put pressure upon the sutures, potentially causing them to come undone.
To minimise these problems, medical practitioners should provide a patient with the following advice before she is discharged home:
- Eat a high fibre diet after the repair to produce a softer stool
- Avoid straining or pushing when defecating
- Support the perineum with a hand while passing a stool
- Take laxatives such as Lactulose to soften stools
- Drink lots of water to prevent dehydration
- Sit forward when defecating
- Clean the area thoroughly after defecating to help avoid infection
- Seek medical help if you are unable to pass a stool or you are experiencing recurrent episodes of incontinence
As long as this advice is followed, a woman should find that normal function returns within weeks or months. The exact amount of time it takes will depend upon the individual and the type of perineal tear sustained.
However, a small number of women will experience ongoing issues. If so, medical attention should be sought without delay, as there could be an undiagnosed injury that requires a repair.
One of the most troubling problems after a perineal tear is recurrent episodes of faecal incontinence. If this is affecting you, do not hesitate to ask your GP for a referral to a specialist consultant.
This will give you the chance to find out whether there is anything causing the incontinence. Often it become apparent that a 3rd or 4th degree tear has not been properly diagnosed, meaning there is an unrepaired tear present.
Both 3rd and 4th degree tears involve the anal sphincter complex. If such injuries are not treated, a defect will remain in the anal sphincter, in turn causing the faecal urgency and incontinence.
Is this negligent?
An undiagnosed and unrepaired 3rd degree tear/4th degree tear is negligent. If this has happened to you, resulting in dysfunction, you could be entitled to claim compensation. If you would like to know more, you need to speak to a medical negligence solicitor about making a claim.