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Created on : 12 Jun 2004
Modified on : 01 Dec 2007

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Bibliographical entry (without author) :

The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery. Obstet Gynecol. 2004 Apr;103(4):669-73.

Author(s) :

Sartore A, De Seta F, Maso G, Pregazzi R, Grimaldi E, Guaschino S.

Year of publication :

2004

URL(s) :

http://www.greenjournal.org/cgi/content/abstract/1…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To evaluate the effect of mediolateral episiotomy on puerperal pelvic floor strength and dysfunction (urinary and anal incontinence, genital prolapse).

METHODS: Five hundred nineteen primiparous women were enrolled 3 months after vaginal delivery. Puerperae were divided in 2 groups: group A (254 women) comprised the women who received mediolateral episiotomy and group B (265 women) the women with intact perineum and first- and second-degree spontaneous perineal lacerations. Each woman was questioned about urogynecological symptoms and examined by digital test, vaginal perineometry, and uroflowmetric stop test score. Data were subjected to Student t test and Fisher exact test to assess, respectively, the difference between the mean values and the proportions within the subpopulations. Using a simple logistic regression model to test an estimate of relative risk, we expressed the odds ratios of the variables considered with respect to the control population (group B).

RESULTS: No significant difference was found with regard to the incidence of urinary and anal incontinence and genital prolapse, whereas dyspareunia and perineal pain were significantly higher in the episiotomy group (7.9% versus 3.4%, P =.026; 6.7% versus 2.3%, P =.014, respectively). Episiotomy was associated with significantly lower values, both in digital test (2.2 versus 2.6; P <.001) and in vaginal manometry (12.2 versus 13.8 cm water; P <.001), but not in uroflowmetric stop test.

CONCLUSION: Mediolateral episiotomy does not protect against urinary and anal incontinence and genital prolapse and is associated with a lower pelvic floor muscle strength compared with spontaneous perineal lacerations and with more dyspareunia and perineal pain.
LEVEL OF EVIDENCE: II-2

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Plus de dyspareunie et douleur, moins de tonus musculaire, avec une épisiotomie médiolatérale que sans.

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ perineal/vaginal tears ; dyspareunia ; incontinence/prolapsus ; episiotomy

Author of this record :

Cécile Loup — 12 Jun 2004