Postpartum Urethral Issues: Seeking Solutions for Painful Intercourse

Postpartum urethral issues?

Hello, doctor.
It has been almost three months since I gave birth.
My baby was born weighing only 2508 grams, so the attending physician decided not to perform an episiotomy, believing that my wound would heal quickly.
However, I have noticed that the distance between my vaginal opening and urethral opening is about 0.5 cm.
When my husband inserts his penis, it constantly rubs against my urethral opening, causing me pain.
We have also used lubricant, but the pain persists.
Is there any way to improve this situation? Otherwise, we will be unable to have normal sexual intercourse.
Should I see a doctor for this? Would it be a gynecologist, or someone else? Thank you for your help.

Xiao Jie, 30~39 year old female. Ask Date: 2016/03/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, there should be no wounds between your vagina and urethra.
Even if there were any, they should have healed after two to three months.
If there is still no improvement, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2016/03/15

More Info

Postpartum urethral issues can be quite distressing, especially when they interfere with intimacy and overall quality of life. It sounds like you are experiencing discomfort during intercourse due to the anatomical changes that occurred during childbirth, particularly the proximity of your vaginal and urethral openings. This is not uncommon, especially after a vaginal delivery, and it can lead to painful experiences during sexual activity.

First and foremost, it is essential to consult a healthcare professional about your symptoms. A gynecologist or a urogynecologist would be the most appropriate specialists to evaluate your condition. They can perform a thorough examination to assess the anatomy of your pelvic region and determine if there are any underlying issues contributing to your pain. This may include checking for any scarring, inflammation, or other complications that could be affecting your urethra and vaginal canal.

In the meantime, here are some suggestions that may help alleviate your discomfort:
1. Use Adequate Lubrication: While you mentioned that you are already using lubricants, it may be beneficial to experiment with different types. Water-based lubricants are common, but silicone-based lubricants can provide longer-lasting moisture and may reduce friction more effectively.

2. Take Your Time: Engaging in foreplay can help increase arousal and natural lubrication, which may ease discomfort during penetration. Ensure that both you and your partner are comfortable and relaxed before attempting intercourse.

3. Positioning: Certain sexual positions may reduce discomfort. Experimenting with different positions can help you find one that minimizes friction against the urethra. Positions where you have more control over the depth and angle of penetration may be particularly beneficial.

4. Pelvic Floor Exercises: Strengthening your pelvic floor muscles through Kegel exercises can improve muscle tone and control, which may help with discomfort. However, it’s crucial to ensure that you are performing these exercises correctly, so consider seeking guidance from a pelvic floor physical therapist.

5. Avoid Irritants: Be mindful of any products that may irritate the vaginal area, such as scented soaps, douches, or certain contraceptives. These can exacerbate discomfort and should be avoided.

6. Consider Hormonal Changes: If you are breastfeeding, hormonal changes can lead to vaginal dryness, which may contribute to pain during intercourse. Discussing this with your healthcare provider may lead to recommendations for vaginal moisturizers or other treatments.

7. Follow-Up Care: Since your symptoms have persisted for several months, it is crucial to follow up with your healthcare provider. They may recommend additional treatments, such as physical therapy for pelvic pain, topical treatments, or even surgical options if necessary.

In summary, while it is common to experience some discomfort postpartum, especially after a vaginal delivery, it is essential to seek medical advice to rule out any serious issues and to explore treatment options. Your comfort and well-being are paramount, and addressing these concerns with a healthcare professional will help you find the best path forward for a fulfilling sexual relationship.

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