Improving the State-of-the-Art for Vaginal Laceration Repair

Vaginal tearing affects 80% or more of women during vaginal childbirth*. Vaginal laceration repairs are one of the most common surgical procedures practicing OB/GYNs must perform for their patients. There are about 3.6 million childbirths annually in the United States, of which close to 68% are vaginal deliveries**. This means there are nearly 2 million vaginal tear repair procedures annually in the United States alone.

Current, most common methodology for vaginal repair requires the OB/GYN to hold open the vaginal walls and tissues with one hand, while suturing the tears with the other hand. Though doctors become adept at doing this, the method is nonetheless cumbersome, as the doctor has one hand fully occupied holding open the vaginal walls for visualization and access, while using the other hand to blot with a gauze pad, suture, tie knots, and cut the suture. Even the most experienced OB/GYNs have a small risk of needlesticks or injury during the procedure.

To avoid the two-handed approach, the OB/GYN might request an assistant to hold a metal sidewall vaginal retractor to enable easier repair, but this requires an extra set of hands, which are not always available, and the metal retractor may cause further damage to sensitive vaginal tissue.

The number of vaginal tear repairs performed regularly by OB/GYN doctors deserves an improved approach to enable easier access, visualization, and a quicker and safer overall procedure. To address this need we developed the Soviflex™ self-retaining vaginal retractor.

The Soviflex retractor is a silicone device designed to fold and insert into the vagina where it will hold the vaginal walls open for the doctor, freeing both hands to repair a vaginal laceration or episiotomy incision. The device can easily be positioned to visualize sidewall tears as well. The device is soft and flexible, so that it will not further damage the vaginal tissues, yet it still provides enough outward tension to enable excellent visualization and access for the surgical procedure. There are two versions of the device (both included in every package), which are color coded blue and yellow to address different patient types. The blue version is softer and more flexible and provides the correct amount of retraction for most patients. The yellow version is made from a harder silicone to provide greater strength in holding the vaginal walls open for patients who may have relaxed and redundant tissue (more likely in a multiparous patient).

The Soviflex™ retractor is an inexpensive, compact, sterile packaged device for one-time use and disposal that can be easily included on every delivery table.

The Soviflex retractor improves access and visualization for faster and safer post-vaginal child-birth vaginal laceration repair. I’ve been using the Soviflex retractor in my own practice for a few months now and I’ve found it to be an elegant solution for the solo provider attending a delivery. Furthermore, I believe the Soviflex retractor will benefit academic teaching centers by making it easier and quicker for students to repair vaginal lacerations without instructors needing to hold open the vaginal introitus, while also providing instruction. It’s time to improve the state-of-the-art for vaginal tear repairs.

About the Author

Catherine Buerchner, M.D. is a practicing OB/GYN at Scripps Clinic Medical Group and a co-founder of Birch Concepts, LLC which has developed the Soviflex™ self-retaining vaginal retractor.

*BMC, 2020
**NCHS, 2022