Health Organization for Pudendal Education

Since I have been seeing my new PT, my pain has started to localize to my right side in the perineum. Yesterday, I took a look around down there and I have an ugly scar in that location. I'm not sure if I tore or if I was cut. My first baby (now 16) was 9 lbs. 6 ozs. And 23 inches long. I was 118 lbs pre-pregnancy so it was a bit traumatic for me. I was very sore in the perineum and had really bad hemorrhoids. I was in so much pain that when my milk came in and I started having pain with breastfeeding I couldn't handle another source of pain and just stopped.

Is scar tissue from a tear or episiotomy a cause for PN? I've read a little about a Fenton's procedure where the dr recuts the scar to get rid of it and then stitches it back together. Anyone familiar with this?

I have requested that my dr send a RX to DR Potter for me but he's out of the office until Monday.

I have read that dysesthetic (unprovoked, generalized) vulvodynia can start with women complaining of continued pain post epsiotomy/tear site. Dr. Elizabeth Stewart, author of "The V Book" http://www.thevbook.com, calls dysesthetic vulvodynia pudendal neuralgia. I personally don't think an episiotomy or tear scar tissue can cause PNE unless possibly from a 4th degreee laceration. I had a 2nd degree tear that caused me a good deal of pain and my PT used ultrasound on the area which seemed to help break up the scar tissue. My PT even uses ultrasound on me now and it helps a little. So you might try that.

I am familiar with the procedure you mentioned, but I don't think it be beneficial to you now 16 years postpartum. Is that the only area you have pain? I think a surgery in that area could worsen your PN symptoms as the nerve is already irritated.

While I have not specifically heard of an episiotomy scar being involved in PN, I know they can be involved in pelvic pain syndromes because my BFF had a 4th degree tear with her 1st childbirth, got acute interstitial cystitis symptoms 4 years later during her 2nd pregnancy, went to pelvic floor PT, and got significant relief just from the PT manually working on the scar (awkward, but I don't think any of us have any shame left anyhow).