Dr. Michael Safir Southern California Center For Advanced Urology

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Perineoplasty - About the Treatment

About the Perineoplasty Procedure

Perineoplasty is a surgery that is designed to either tighten or loosen the perineal muscles of the vagina. Perineoplasty is also sometimes called perineorraphy.


Tightening Perineoplasty

According to Los Angeles urologist Dr. Michael Safir, “The most common type of perineoplasty we perform is a tightening perineoplasty.” Many women who have had difficult vaginal deliveries suffer from torn or weakened perineal muscles. Women who have gained weight may also find that their perineum has stretched and the muscles have loosened. Some women may also elect to have perineoplasty because they find their muscles have become lax as they’ve gotten older. By undergoing a tightening perineoplasty procedure, these women are able to have their perineum tightened, restoring their natural anatomy.


Often, perineal damage is accompanied by some type of pelvic prolapse. Because Dr. Safir specializes in pelvic floor reconstruction, he can perform pelvic prolapse surgery to correct cystocele (bladder prolapse) or rectocele (rectal prolapse) at the same time as the perineoplasty procedure.

Many patients have perineoplasty as part of a total vaginal restoration. Total vaginal restoration comprises several different procedures designed to address both aesthetic and functional concerns. These procedures include labiaplasty, vaginoplasty, and perineoplasty.


Loosening Perineoplasty

Another type of perineoplasty is designed to loosen the perineal muscles of the vagina. Women who experience painful intercourse – a condition called dyspareunia - due to an overly tight vaginal entry find that this type of perineoplasty surgery allows them to enjoy intercourse, whereas before it had always been a painful ordeal.


The Perineoplasty Procedure

As there are multiple types of perineoplasty, the exact procedure will vary according to your needs.


Sedatives and pain relievers are administered to reduce anxiety

  • Drugs are administered to reduce anxiety and pain before the procedure begins.
  • Local anesthetic is injected into the area.
  • Dr. Safir then performs the perineoplasty by making an incision, and possibly removing and scar tissue from the perineal muscles in the posterior wall of the vagina.
  • After the procedure is completed, the area is carefully sutured to make sure it heals properly.
  • The entire procedure is usually completed in under an hour

If the perineoplasty is being performed as part of a total vaginal restoration, or in addition to other pelvic floor repairs, such as correction of pelvic prolapse, these will be performed concurrently, and the procedure will take longer.

The Difference That Dr. Safir Brings...

Dr. Michael Safir is not only a board-certified urologist; he is also a nationally-renowned urologic surgeon. He specializes in the rapidly developing field of reconstructive urology. Dr. Safir is one of only a handful of urologists worldwide to have completed separate fellowship training in reconstructive female urology surgery (at UCLA) and male genitourinary surgery (at UCSF). The American Board of Medical Specialties has just recently recognized female pelvic reconstructive surgery as a distinct subspecialty.

Dr. Safir lectures at medical conventions and seminars, and travels throughout the country training other urologists and gynecologists in the latest, advanced techniques for surgical treatment of urinary incontinence and pelvic prolapse.

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Frequently Asked Questions
about Perineoplasty

Video Blog

Michael Safir, M.D. speaks candidly about various urological conditions and the advanced surgical procedures used in his practice.

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