What is Vaginal Laceration

Vaginal laceration is a cut or tear of the opening of your vagina, the inside of the vaginal canal, or the skin between your vaginal opening and your anus (perineum).

What are the causes?

This condition may be caused by:

• Childbirth, or tools used to help deliver a baby, such as forceps.
• Sex.
• An injury from sports, bike riding, or other activities.
• Thinning, dryness, or irritation of the vagina due to low estrogen levels (vulvovaginal atrophy).

What increases the risk?

This condition is more likely to occur in women who:

• Give birth vaginally.
• Are sexually active.
• Have gone through menopause.
• Have low estrogen levels due to certain medicines, breast cancer treatments, or breastfeeding.

What are the signs or symptoms?

Symptoms of this condition include:

• Slight to heavy vaginal bleeding.
• Vaginal swelling.
• Mild to severe pain.
• Vaginal tenderness.
• Painful urination.
• Pain or discomfort during sex.

How is this diagnosed?

If the tear happened during childbirth, your health care provider can diagnose the tear at that time. Your health care provider can diagnose other tears with a medical history and physical exam. Other tests may be done, including:

• Blood tests to check your hormone levels and blood loss.
• Imaging tests, such as an ultrasonogram or CT scan, to rule out other health issues, such as enlarged lymph nodes or tumors.

How is this treated?

Treatment depends on the severity of the tear. Minor tears may heal on their own. Other treatment may include:

• Stitches (sutures).
• Medicines, such as:
  • Creams to reduce pain.
  • Vaginal lubricants to treat vaginal dryness.
  • Topical or oral hormonal therapy.
  • Antibiotics. These may be taken orally or given as ointments to prevent or treat infection.

Surgery may be needed if the tear is severe.

Follow these instructions at home:

Wound care

• Follow instructions from your health care provider about how to take care of your tear. Make sure you:
  • Keep the area clean.
  • Leave sutures in place, if this applies. These skin closures may need to stay in place for 2 weeks or longer.
• If directed, apply ice to the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Check your wound every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Medicines

• Take or apply over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic, take or use it only as told by your health care provider. Do not stop taking or using the antibiotic even if you start to feel better.

General instructions

• Take a sitz bath 2–3 times a day or as told by your health care provider. A sitz bath is a shallow, warm water bath that is taken while you are sitting down. The water should only come up to your hips and should cover your buttocks.
• Avoid sitting or standing for long periods of time.
• Lie on your side while sleeping or resting.
• Avoid straining during bowel movements. Ask your health care provider if a stool softener would help.
• Do not douche, use a tampon, or have sex until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain in the vaginal area.
• You have more fluid or blood coming from your vaginal tear.
• You have pus or a bad smell coming from your vaginal area.
• You have a fever.
• Your tear breaks open after it healed or was repaired.
• You continue to have pain during sex after the tear heals.
• You have a burning pain when you urinate.
• You are urinating more often than usual or feel an increased urgency to urinate.

Get help right away if:

• You feel lightheaded.
• You have nausea or vomiting.
• You have severe pain around your vagina, or in your pelvis or lower belly.
• You have heavy vaginal bleeding or you are soaking more than 1 pad per hour.