Your visit to the perineal clinic

You have been referred to the Perineal Trauma Clinic. This page explains:

• What the Perineal Trauma Clinic is.
• How to prepare for this visit.
• What to expect during the consultation.

The Perineal Trauma Clinic is a specialised clinic that looks after mothers who sustain a tear to the anal sphincter (the muscle that controls the back passage) at the time of child birth.

You will need to complete a questionnaire about your health covering the problems with its various symptoms. For each question, please circle the answer that you feel describes your condition best.

It will enable a thorough assessment of your condition and its effect on your quality of life. This will help accurate diagnosis of any problem(s) and guide the best way to deal with it (them).

Being in clinic can cause anxiety such that patients forget problems or get embarrassed to raise them. Posting the questionnaire before the appointment will help you document all your problems before hand.

If you prefer not to fill the questionnaire, your history will be taken by asking you questions and your care will not be affected.

During your visit to the Perineal Trauma Clinic, a doctor will ask about your symptoms and check your completed questionnaire with you. This is to ensure proper understanding of your condition.

The tear you had at the time of delivery will be explained to you again, to ensure you understand what happened. If you were not given a patient information leaflet about the tear you had at the time of delivery, one may be given to you.

You may undergo an examination which may include:

• An inspection of the wound, to assess its healing.
• Digital examination of the pelvic floor muscles. This will entail some form of pressure on either side of the front passage. This is done to assess the tone of the muscles that support the bladder and the vagina. You may be asked to contract (pull up) your pelvic floor muscles  during this part of the examination.
• Digital examination of the back passage, to assess the strength of the anal sphincter (muscle that controls the back passage). This is to ensure it has healed well.

The doctor will then explain the findings to you and discuss various options for investigation and management with you.

On the basis of assessing your condition, you will be advised whether a future vaginal delivery is safe or not.

We hope you will find your visit to the clinic comfortable, informative and helpful.

You will find further information about urogynaecology services at the urogynaecology section of the Trust website.

Princess Royal Hospital, Horsted Keynes Ward: 01444 441881 Extension 65686

Royal Sussex County Hospital, Level 11: 01273 523191

Urogynaecology Unit at Lewes Victoria Hospital: 01273 474153 Extension 2178

This patient information was prepared by Dr. Sharif Ismail, Consultant Subspecialist Urogynaecologist.

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.