Most patients seen in our pelvic floor clinic have had vaginal deliveries. Almost all of them have perineal body dehiscence sometimes with perineocele.
These patients experience flatal incontinence, constipation, splinting the perineum for defecation assistance, and unsatisfactory sexual experiences because of excessive vaginal looseness, can benefit from perineal body repair.

We demonstrate our surgical technique for repairing the anatomical perineal body area based upon the Integral Theory by Peter Petros. We applied this technique to all the patients who have perineal body dehiscence as a complement of other pelvic floor repair since 2007.
It is a quick surgery between 15-20 minutes with few complications.
In the last 19 years of experience, we have only had 2 anal perforations as complications, which were resolved instantly.

The patients with the symptoms mentioned above, after surgery, did not need splinting of the perineum for assisting defecation anymore, the flatal incontinence disappeared and patients returned to satisfactory sexual  intercourses.
Patients did not experience perineal pain after surgery because the incision and suture were inside the vagina.

The perineal body is the anatomical stabilizer of the area encompassing the rectovaginal muscularis mucosa, the distal vagina, and the anus.
The perineal body is bilaterally attached to the deep transverse perineal muscle. When this muscle dehisces, it can cause bothersome symptoms for the patient. Suturing the perineal body reconstructs it, restoring balance and eliminating symptoms, thus improving the patient's quality of life.
This is a simple and quick surgery with few complications.
We recommend applying this technique more often as part of comprehensive surgical repair of the pelvic floor.

The Female Pelvic Floor: Function, Dysfunction and Management According to the Integral Theory, 3th Edition, 2010. ISBN-13 978-3642037863 Ed. Springer
Wagenlehner FME, Del Amo E, Santoro GA, Petros P. “Perineal body repair in patients with third degree rectocele: a critical analysis of the tissue fixation system”. Colorectal Disease. 2013 Dec. 15; 12: e760–e765
Hodgson R, Wagenlehner F, Del Amo E, Inoue H, Abendstein B .Descending perineal syndrome cure by deep transversus perinei ligament repair: surgical options. Ann Transl Med. 2024 Apr 22;12(2):32. doi: 10.21037/atm-23-1803. 	Epub 2024 Apr 18