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Ask Dr. Pfeiffer Your Own Question

Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience:  Ob/Gyn Doctor
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I have a fissure at what I believe is referred to as the "posterior

Customer Question

I have a fissure at what I believe is referred to as the "posterior fourchette" of the vagina. This has been present for about 3 years, and has never seemed to heal completely. It looks like a small (1/4" long) cut that has some possibly scarred tissue on either side with red tissue in the center that bleeds a tiny bit if I put pressure on it, or sometimes after sex. I have asked three OB/GYNs and two GPs about this issue but no one could recommend a solution. The spot was cultured for herpes, and I had a herpes blood test; both came back negative as well as tests for other STDs. I do not have a yeast infection or itching.
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Pfeiffer replied 1 year ago.

Dr. Pfeiffer :

hello

Dr. Pfeiffer :

how old are you?

Dr. Pfeiffer :

have you had any children vaginally?

Customer:

27, no children

Customer:

are you there?

Dr. Pfeiffer :

yes...finally

Dr. Pfeiffer :

wouldn't connect..


that said I don't see your replies to my questions

Dr. Pfeiffer :

how old are you?


have you had any children vaginally?

Customer:

27

Customer:

no children

Dr. Pfeiffer :

ok.


the area is in fact the posterior forchette

Dr. Pfeiffer :

did you suffer a tear there before?

Dr. Pfeiffer :

what happened 3 years ago?

Customer:

nothing...it just appeared after normal intercourse, and this is the same tear which never seemed to heal fully and becomes re-irritated with normal, lubricated intercourse. The timing of the tear may have coincided with starting hormonal birth control (nuva ring) which made me feel very dry, but i don't remember exactly. I stopped the birth control about 2 years ago, but it never seemed to heal up.

Customer:

I have been with the same partner the entire time

Dr. Pfeiffer :

ok...


is this your one and only partner?

Customer:

no

Dr. Pfeiffer :

were you every assaulted or molested as a young woman/girl?

Customer:

no, there was never an injury or assault, or any type of consensual rough sex that happened

Dr. Pfeiffer :

ok...

Dr. Pfeiffer :

doesn't sould like anything serious

Dr. Pfeiffer :

small tears can certainly happen with normal intercourse.

Dr. Pfeiffer :

the tears can be aggrivated by subsequent intercourse.

Dr. Pfeiffer :

this is usually due to scar tissue formation that is less elastic than the normal vaginal tissue.

Dr. Pfeiffer :

One thing I think I would at least try is vaginal estrogen for about 6 weeks.

Dr. Pfeiffer :

the estrogen helps the vaginal tissue become more robust.

Dr. Pfeiffer :

if you were a bit older and had children..another option would be excision and repair.

Dr. Pfeiffer :

However, at your current age I wouldn't suggest this until you are done with having children.

Customer:

will this be a problem when I do have children?

Dr. Pfeiffer :

and that is because you are likely to tear during delivery and the excision/repair would be ruined.

Dr. Pfeiffer :

No..I suspect you'll tear along the same line

Dr. Pfeiffer :

It can be repaired at that time.

Customer:

tearing doesn't sound good...why is that not a problem?

Dr. Pfeiffer :

yea...I understand that.

Customer:

and what if I would like to have multiple children?

Dr. Pfeiffer :

that said...picture a football coming out of the vagina

Dr. Pfeiffer :

pretty amazing that it happens to begin with.

Dr. Pfeiffer :

some trauma is almost universal with the first child

Dr. Pfeiffer :

I think you'll be fine to have multiple children...in the long run.

Dr. Pfeiffer :

what you have going on now might just respond to the estrogen and not even be a problem going forward with delivering children.

Customer:

Since that is a prescription, how would you recommend bringing that up with my physician? I have honestly asked 5 different docs and 4 of those have examined it, none offered a solution except to scrape it and test it for herpes even though that had already been done after the first time...one was downright dismissive when I told her it had already been tested for herpes

Dr. Pfeiffer :

yes, I can imagine.

Dr. Pfeiffer :

I would simply say I have seen 4-5 ob/gyns with no resolution.


you were online and discovered that vaginal estrogen may make the tissue more robust in this area.

Dr. Pfeiffer :

I think that is a reasonable idea and understanding that most ob/gyns would consider.

Customer:

ok, and what would you try next if that suggestion didn't resolve the issue?

Dr. Pfeiffer :

I would probably biopsy it...and then consider excision/revision...as a last resort.

Customer:

and what would you be looking for in a biopsy?

Dr. Pfeiffer :

chronic skin problem - immune mediated


bacterial and viral infections - outside of the herpes testing you have already had done.

Customer:

ok

Dr. Pfeiffer :

alright...


if there is nothing else I can do for you please take the time to rate my service.


thank you


Dr. Pfeiffer

Customer:

ok, thank you for your time!

Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience: Ob/Gyn Doctor
Dr. Pfeiffer and other OB GYN Specialists are ready to help you

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