Vaginal Laceration

ExitCare ImageA vaginal laceration is a tear in the vaginal wall. A vaginal tear falls into one of three categories:

  1. Obstetrically related tears that occur at the time of childbirth.

  2. Trauma-related tears (most often related to sexual intercourse).

  3. Spontaneous tears.

Vaginal tears can cause heavy bleeding (hemorrhaging) depending on severity of the tear. Tears can be intensely tender and interfere with normal activities of living. They can make sexual intercourse painful and bring on significant burning with urination. If you have a vaginal laceration, the area around your vagina may be painful when you touch or wipe it. Even light pressure from clothing may cause some pain. Vaginal tear need to be evaluated by your caregiver.  

CAUSES

  • Obstetric-related causes, such as childbirth.

  • Trauma that may result from an accident during an activity, such as sexual intercourse or a bicycle ride.

  • Spontaneous causes related to aging, failed healing of a past obstetric tear, chronic irritation, or skin changes that are not well understood.

SYMPTOMS

  • Slight to heavy vaginal bleeding.

  • Vaginal swelling.

  • Mild to severe pain.

  • Vaginal tenderness.

DIAGNOSIS

If the tear happened during childbirth, your caregiver can diagnose the tear at that time. To diagnose a vaginal tear that happened spontaneously or because of trauma, your caregiver will perform a physical exam. During the physical exam, your caregiver may also look for any signs of trouble that may need further testing. If there is hemorrhaging, your caregiver may suggest blood tests to determine the extent of bleeding. Imaging tests may be performed, such as an ultrasonography or computed tomography (CT), to look for internal damage. A biopsy may be need if there are signs of a more serious problem.

TREATMENT

Treatment depends on the severity of the tear. For minor tears that heal on their own, treatment may only consist of keeping the area clean and dry. Some tears need to be repaired with stitches. Other tears may heal on their own with help from various remedies, such as antibiotic ointments, medicated creams, or petroleum products. Depending on the circumstances, oral hormones may also be suggested. Hormone remedies may also be in the form of topical creams and vaginal tablets. For more concerning situations, hospitalization and surgical repair of the tear may be needed.

HOME CARE INSTRUCTIONS

  • Take warm-water baths that cover your hips and buttocks (sitz bath) 2 to 3 times a day. This may help any discomfort and swelling.  

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Do not use aspirin because it can cause increased bleeding.  

  • Do not douche, use tampons, or have intercourse until your caregiver says it is okay.   

  • A bandage (dressing) may have been applied. Change the dressing once a day or as directed. If the dressing sticks, soak it off with warm, soapy water.  

  • Apply ice or witch hazel pads to the vagina to lessen any pain or discomfort.  

  • Take a stool softener or follow a special diet as directed by your caregiver. This will help ease discomfort associated with bowel movements.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have redness or swelling in the vaginal area.  

  • You have increasing, sharp, or intense pain or tenderness in the vaginal area.

  • You have pus or unusual discharge coming from the tear or vagina.  

  • You notice a bad smell coming from the vagina.  

  • Your tear breaks open after it healed or was repaired.  

  • You feel lightheaded.

  • You have increasing abdominal pain.  

  • You have an increasing or heavy amount of vaginal bleeding.  

  • You have pain with intercourse after the tear heals.  

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.