What Is a Perineal Incision?

A perineal incision is a surgical incision. In a woman, the incision is between the anus and vagina; for a man, the incision is between the anus and scrotum. A perineal incision cuts through both skin and muscle. It is typically used in females during the delivery of their babies. Perineal incisions for men occur during various medical procedures, including prostate removal.

The perineal incision for the purpose of delivering a baby is also called an episiotomy. An incision is made during the final stage of labor to reduce the risk of a perineal tear as the baby is delivered. A tear carries an increased risk of infection. The perineal incision eliminates uneven tears, which would be more difficult to suture. Immediately following the infant's delivery, the incision is sutured.

Reasons to consider a perineal incision during labor include breech deliveries, premature deliveries, and large-baby deliveries. In premature deliveries, the incision protects the baby from perineal pressure during birth. For large babies, it reduces the risk of the infant's shoulders getting stuck. In a breech birth, it provides a safer delivery.

Local anesthesia is typically given before the incision is made. At the same time, as the baby's head begins to stretch the vagina's opening, the physician makes a 1-inch (2.5 centimeters) cut through the skin. The incision is closed with dissolving sutures. Possible complications include infection, bleeding, painful intercourse, and swelling. Home care for a perineal incision includes keeping the area clean, applying medicated sprays, and soaking in a cold bath.

A perineal incision is sometimes used during a prostatectomy. This surgery removes the prostate. The patient is given an enema the night before surgery. General anesthesia is used for the prostate removal. This eliminates the need for local anesthesia for the incision.

Care for a perineal incision on a male patient is similar to care for a female patient. The incision area must be kept clean and dry. Medical care should be sought at the first sign of infection. Symptoms of infection include fever, drainage of pus from the incision, or swelling.

Complications from the incision are rare. Scarring, pain during intercourse, and numbness have been reported. Patients should consult with their physicians regarding the decision to have the incision during their medical procedures. In addition, patients should inform the physician if they have had prior issues with excessive bleeding during surgery or dental work.