Fenton's repair

Summary

A Fenton's repair (Fenton's procedure) is a small operation to widen the entrance of the vagina by releasing tight scar tissue or a band of skin at the perineum — most often scarring left by childbirth tears, episiotomy or previous surgery that makes sex painful or impossible. It is mainly performed in resistant cases of vaginismus, where other treatment options have been unsuccessful.

• A short day procedure — about 20–30 minutes under general or spinal anaesthetic.
• The scarred band is divided and the skin re-stitched in a way that widens the opening; stitches dissolve on their own.
• Healing takes about 4–6 weeks; most women notice a real difference once healed.
• Usually offered after simpler measures — dilators, physiotherapy, local oestrogen — have been tried where appropriate.

This information supports discussion with your healthcare team. Reading, saving or printing it does not constitute consent to surgery.

About the operation

After a tear or episiotomy heals, the scar at the entrance of the vagina can be tight, rigid or tender — a physical band that stretching cannot loosen. A Fenton's repair removes or divides that scar: the tight tissue is cut, the underlying tissue released, and the edges re-stitched side-to-side so the opening is wider and the scar line lies in a more comfortable direction.

It is honest to say this operation treats a physical narrowing. Painful sex has many causes — including vaginismus (involuntary muscle tightening) and dryness — that surgery does not fix, which is why examination and the right diagnosis come first. Our vaginismus article covers the muscle-related side.

Why it is performed

• Painful sex from a tight, scarred perineum after childbirth or surgery
• Recurrent splitting of a rigid scar at the entrance
• Narrowing after previous repairs, surgery or skin conditions, once the skin condition itself is controlled

Benefits

• Comfortable sex again — the majority of well-selected women report substantial improvement once healed.
• A quick, low-risk day procedure with dissolvable stitches.

Alternatives

• Vaginal dilators and pelvic floor physiotherapy — first-line for many women, especially where muscles contribute.
• Local oestrogen cream — where dryness or menopausal change is part of the picture.
• Scar massage and time — younger scars often soften over months.
• Botox injection — an injection that relaxes the vaginal muscles; an alternative in selected cases.

Preparing for surgery

You will have an examination to confirm the scar band is the problem, and routine checks — blood pressure, a medicines review, and blood tests where needed. Tell the team about all medicines you take.

• Fasting: typically no food from 6 hours before, water up to 2 hours before.
• At home: arrange someone to take you home; plan a few quiet days.

The day of surgery

You are admitted on the day. The team confirms your identity and the plan, you meet the anaesthetist and surgeon, and you sign the consent form. You can still change your mind at this point.

During the operation

Under general or spinal anaesthetic, with your legs supported, the surgeon divides the scarred band at the vaginal entrance, releases the tissue beneath, and closes the skin transversely with fine dissolvable stitches so the entrance is wider. The procedure takes about 20–30 minutes.

After the operation

• Soreness at the entrance for one to two weeks; simple painkillers and cool packs help.
• Stitches dissolve by themselves over 2–4 weeks.
• Going home the same day once comfortable and passing urine.

Recovery at home

• Keep the area clean and dry: shower rather than bathe for the first days, pat dry, wear loose cotton underwear.
• Avoid cycling, swimming and heavy exercise for 2–3 weeks.
• Sex: wait until fully healed and comfortable — usually 4–6 weeks. Start gently; a lubricant helps.
• Most women are back at work within a few days to a week.

Risks and complications

Expected, temporary effects

• Soreness, swelling and spotting for a week or two

Complications

• Infection or wound breakdown — usually managed with dressings and antibiotics; occasionally needs re-stitching (uncommon).
• Bleeding or haematoma (uncommon).
• Scar re-forming or persistent discomfort — a further procedure or physiotherapy is sometimes needed (uncommon).
• Anaesthetic risks — serious complications are rare.

When to seek help

After you go home, seek medical advice the same day if you notice:

• Heavy bleeding from the operation site or vagina
• Fever (38 °C or higher) or feeling increasingly unwell
• Worsening pain not controlled by your painkillers
• An offensive-smelling discharge
• The wound opening up, or increasing swelling at the site
• Being unable to pass urine

Preparing for your consent discussion

Consent is a conversation, not a signature. Before agreeing you should feel you understand why this procedure is recommended for you, what the realistic alternatives are, and which risks matter most in your case. Print this checklist and bring it to your consultation.

Sources and review

This page was drafted against the published guidance below. Each reference was live when checked; dates will be confirmed at clinical review.

1. Royal College of Obstetricians and Gynaecologists. Perineal tears and episiotomy — patient information. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/ [last checked 12 August 2026].
2. National Health Service (UK). Episiotomy and perineal tears. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/episiotomy-and-perineal-tears/ [last checked 12 August 2026].