Anal incontinence and fecal urgency following vaginal delivery with episiotomy among primiparous patients
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
27641426
DOI
10.1016/j.ijgo.2016.06.025
PII: S0020-7292(16)30350-2
Knihovny.cz E-resources
- Keywords
- Anal incontinence, Childbirth, Episiotomy, Fecal urgency, Vaginal delivery,
- MeSH
- Adult MeSH
- Episiotomy adverse effects MeSH
- Fecal Incontinence epidemiology etiology MeSH
- Obstetric Labor Complications epidemiology MeSH
- Humans MeSH
- Young Adult MeSH
- Follow-Up Studies MeSH
- Parity MeSH
- Perineum surgery MeSH
- Postpartum Period MeSH
- Prospective Studies MeSH
- Surveys and Questionnaires MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
OBJECTIVE: To investigate anal incontinence following mediolateral or lateral episiotomy during a first vaginal delivery. METHODS: The present prospective follow-up study enrolled primiparous patients who underwent vaginal delivery including mediolateral or lateral episiotomy between April 1, 2010 and March 31, 2012. Participants completed interviews before delivery, and were given anal-incontinence questionnaires to be returned for analysis at 3 months and 6 months postpartum. Anal incontinence was defined as a St Mark's incontinence score above four and individual anal-incontinence components were analyzed separately; results were compared between the two episiotomy techniques. RESULTS: Questionnaires were returned by 300 and 366 patients who underwent mediolateral and lateral episiotomies, respectively; baseline characteristics were similar. Anal incontinence at 3 months and 6 months was recorded among 21 (7.0%) and 9 (3.0%) patients who underwent mediolateral and 27 (7.4%) and 20 (5.5%) who underwent lateral episiotomy, respectively. The study was underpowered to confirm equivalence between the groups; however, no statistically significant differences were observed in the rates of anal incontinence, flatus, solid or liquid incontinence, and de novo incontinence. Fecal urgency (P=0.017) and de novo fecal urgency (P=0.008) were more prevalent among patients who underwent lateral episiotomies at 6 months. CONCLUSION: Anal incontinence was comparable between primiparous patients who underwent mediolateral or lateral episiotomy. The association between lateral episiotomy and fecal urgency merits further scientific interest.
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