Allodynia at episiotomy scar as an unusual cause for dyspareunia: a case report

Even though an episiotomy, a common perineal incision made during childbirth, is intended to prevent perineal trauma, significant postpartum complications such as perineal pain and dyspareunia may occur by it. We describe a case of a 45-year-old mother of two children, who presented with superficial dyspareunia affecting her sexual and social relationships. Despite normal ultrasound and abdominal examination findings, allodynia at the site of a previous episiotomy scar was found during the perineal examination. Surgical excision was performed as conventional analgesics and lidocaine provided inadequate pain relief. The efficacy of surgical intervention is underscored by the non-recurrence of dyspareunia over a one-year follow-up period. The importance of a thorough evaluation in diagnosing dyspareunia and multidisciplinary approach in management are highlighted in this case report, as pain sources may not be immediately apparent. Keywords: episiotomy scar; allodynia; postpartum dyspareunia; perineal pain. Citation: Ratnayake A, Gnanarathne S, Thangavadivale V, Egodage S, Sandaru G. Allodynia at episiotomy scar as an unusual cause for dyspareunia: a case report. Anaesth. pain intensive care 2024;28(6):1135-1137. DOI: 10.35975/apic.v28i6.2631 Received: September 19, 2024; Reviewed: September 28, 2023; Accepted: September 28, 2023