CHRONIQUE DU Dr Cheick Atab BADJI
Epreuve de la vie qui met la vie à l’épreuve, la maternité, malgré toute sa noblesse, n’est toutefois pas sans séquelles. Au-delà du lourd tribut que le corps de la femme paie en termes de déformations morphologiques touchant l’abdomen et la peau avec ses immanquables vergetures, … signes d’une mission accomplie, quoique mission hautement périlleuse. Cependant, si l’essentiel des modifications est d’ordre esthétique, une relève particulièrement de la vie intime, le périnée.
LA BEANCE DU PERINEE: QU’EN EST IL?
Le périnée, c’est la zone de voisinage immédiat des organes intimes. Chez la femme, au cours de l’accouchement, le périnée se distend pour laisser sortir le bébé. En cas d’étroitesse, surtout notée chez la femme qui accouche pour la première fois par voie basse, c’est à ce niveau qu’on fait une petite incision pour élargir l’orifice de sortie de l’enfant. La réparation de cette incision se faisait autrefois par pose d’agrafes, de petites pinces métalliques qu’on mettait sur plusieurs points. L’image de ces femmes, boitillant ou peinant à s’assoir convenablement le jour du baptême et dont on disait qu’elles avaient une ou plusieurs agrafes » arrache le sourire nostalgique d’un phénomène aujourd’hui dans l’oubli. Les points de suture (au fil) ont aujourd’hui définitivement supplanté ces historiques agrafes. La femme c’est aussi deux choses, deux visages pour paraphraser (en ouolof), celui de la beauté et celui du sensuel. Le second s’appelle le périnée. Il est très important dans la vie de couple, la vie intime. Il est le point final. Ce geste qui consiste à inciser pour ensuite réparer constitue ce qu’on appelle l’ EPISIOTOMIE; elle permet d’éviter la déchirure du périnée qui est parfois difficile à réparer et qui peut se propager vers d’autres structures de voisinage, entrainant ainsi des complications graves. Dans les deux situations, plus fréquemment dans le cas de la déchirure, une mauvaise cicatrisation peut se noter. Celle ci s’accompagne souvent de douleurs lors des rapports intimes. Chez la femme qui a accouché plusieurs fois par voie basse, ou celle qui a accouché par voie basse d’un gros bébé, le périnée devient souvent béant: on parle de béance du périnée; autrement dit, la femme devient « large » du point de vue génital.
CONSEQUENCES DE LA BEANCE DU PERINEE
La femme a l’impression d’être « large » au cours des rapports intimes; elle n’éprouve plus les mêmes sensations sexuelles qu’auparavant. Dans certains cas rares, le conjoint attire l’attention. Mais dans la majeure partie des cas, le débat n’est pas posé au sein du couple, chacun se contentant de constater que » ce n’est plus comme avant » sans savoir exactement pourquoi ou quoi faire. Dans beaucoup de cas inavoués, ceci est à l’origine de la distanciation dans le couple avec un compagnon s’envolant secondairement en noces, à la recherche de nouvelles sensations perdues.
QUELLE SOLUTION?
Dans cette situation de béance du périnée, il n’y a pas d’urgence vitale pour la femme mais parfois il ya bien urgence vitale pour la vie du couple, ou plutôt sa survie dans les meilleures conditions souhaitées. L’arsenal classique du marché de l’odeur et de la perle n’ y font pas grand chose. De vraies solutions sont possibles. C’est la réparation du périnée qu’on appelle REPRISE DU PERINEE. Cette petite intervention, peu connue du grand public mais de plus en plus sollicitée, permet à la femme de retrouver, après sa féconde maternité, une vie intime au moins stable, à défaut d’une seconde jeunesse.
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