METHOD FOR PERINEAL THREAD LIFTING WITH INSUFFICIENT PELVIC FLOOR MUSCLES AND GAPING GENITAL FISSURE Russian patent published in 2025 - IPC A61B17/42 A61B17/04 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, gynaecology, urology, plastic surgery, aesthetic gynaecology. Two oppositely notched monofilament absorbable sutures with atraumatic needles bent 1/2 of a circle are used. Sutures are delivered with using a needle along the vertices of two rhombuses, small and large. Vertexes of rhombuses are formed by dissection of skin: in places of projection of lower edges of bulbospongiosus muscles, in projection of medial parts of puborectal muscles – 10-15 mm above and in medial direction of ischial tuberosities, 5 mm anteriad from the external anal sphincter and on the mucosa of the posterior vaginal wall at the level of the hymenal ring, incision places are tunnelled to form canals and perforate superficial fascia of perineum. Then, using the first thread, performing the first prick in the projection of the posterior part of the left bulbospongiosus muscle with the capture of its myogaster, bringing the thread to the middle of its length, needle is pricked out through an incision in the vaginal mucosa within a hymenal ring. Further through same channel needle is brought in direction of incision above rear edge of right bulbospongiosus muscle, with capture of its myogaster. Other end of the same suture is similarly delivered through a posterior edge of a right bulbospongiosus muscle with covering the superficial transverse muscle of perineum and brought out through an incision in the perineal skin above an upper edge of the anal sphincter. Needle is pricked in for the second time in the same canal and brought out into the incision within a posterior edge of the left bulbospongiosus muscle. Thus, the threads delivered through the tissues form a small rhombus. Second thread is carried out along the vertices of a large rhombus in the opposite direction: starting the needle from the incision in the projection of the medial part of the right pubic-rectal muscle and the ischial tuberosity located above and in the medial direction, needle is inserted with gripping bulbospongiosus muscle, then ligature is brought out into wound canal along posterior wall of vagina. At the second step, passing through the above muscular structures from the opposite side, the suture is brought out through similar incisions from the right. Second half of the suture is delivered through the puborectal and superficial transverse muscles of the perineum and brought out in a point above the external anal sphincter, from which the ligature is delivered into the contralateral point with covering the analogous muscular structures. Needles are dissected away from the sutures starting from the suture brought along the small rhombus; compression is performed on perineal soft tissues combined with traction of the ligatures. Four knots immersed under the superficial fascia into the pre-formed wound canals are tied up; a similar procedure is repeated with the suture brought along the greater rhombus.

EFFECT: method enables correcting the external genital appearance, improving the quality of sexual life in both partners, reducing vaginal dysbiotic processes.

1 cl, 1 dwg, 3 ex