Fortunately for the physical welfare of women, practical unanimity exists among obstetricians regarding the advisability of immediate repair of a laceration of the pelvic floor after labor. Unfortunately, the ultimate results of such an operation are frequently not at all satisfactory, prolapse of the vaginal wall necessitating secondary operative procedures at a later date. The lack of success attending the primary operation is to be attributed to one of three causes, or to a combination of all. First, failure on the part of the operator to appreciate the extent and direction of the subcutaneous tear; second, failure to approximate the edges of the torn muscle and fascia; third, an overstretching of the muscles of the pelvic floor, which can not be overcome or modified except by denudation and suturing of the vaginal wall, an unjustifiable procedure at this stage of the puerperium.
BURTENSHAW JH. LACERATIONS OF THE PELVIC FLOORTHE PRINCIPLES INVOLVED IN THEIR PRIMARY AND SECONDARY REPAIR. JAMA. 1904;XLIII(23):1690–1692. doi:10.1001/jama.1904.92500230001e
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