If we examine the status of the operation for repair of the perineum, we find the following suggestive facts. In the various text-books and standard articles on the subject there are between 25 and 30 different methods described. Running through these we fail to find any common law or principle that governs them. The word perineorrhaphy means simply sewing the perineum. If we were to depend on the study of these operations in order to find out whether it has any-deeper meaning we should conclude that the word is used literally. That is to say, the majority of operations are simply methods of sewing and patching rents or tears. Perineorraphy should imply the restoration of the function of the perineum by restoring the anatomic relation of its structures. Before offering a practical method of repair, there are certain premises that should be accepted. They may be summed up as follows: