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International Urogynecology Journal
Published in: International Urogynecology Journal 6/2019

01-06-2019 | Dyspareunia | Review Article

Incidence of perineal pain and dyspareunia following spontaneous vaginal birth: a systematic review and meta-analysis

Authors: Margarita Manresa, Ana Pereda, Eduardo Bataller, Carmen Terre-Rull, Khaled M. Ismail, Sara S. Webb

Published in: International Urogynecology Journal | Issue 6/2019

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Abstract

Introduction and hypothesis

Perineal pain and dyspareunia are experienced by women undergoing a vaginal birth that can have short and longer term physical and psychological morbidities. This review aimed to determine the incidence of perineal pain and dyspareunia following spontaneous vaginal birth (SVB) with intact perineum, first and second-degree perineal trauma or episiotomy.

Methods

Searches of MEDLINE, EMBASE, CINAHL, AMED and MIDIRS (inception – December 2017) were undertaken with selection criteria of any study evaluating the effect of intact perineum, first- or second-degree perineal trauma on perineal pain or dyspareunia in women with SVB.

Results

Eighteen studies (8 RCTs and 10 NRSs) were included. Fourteen and 12 studies were undertaken to assess perineal pain and dyspareunia after SVB, respectively. Meta-analysis of 16 studies (3133 women) demonstrated that women at 2 days postpartum experienced nearly the same incidence of perineal pain whether perineal trauma existed or not. At 4–10 days postpartum there was a significant reduction in the incidence of perineal pain for both presence and absence of any perineal trauma. Episiotomy was associated with the highest rate of perineal pain. The incidence of dyspareunia was high at resumption of sexual intercourse following SVB with an intact perineum. At 12 months, women still experienced dyspareunia whether perineal trauma existed or not.

Conclusions

Women experience perineal pain and dyspareunia regardless of the presence or absence of perineal trauma after SVB; nonetheless, the reported incidence is higher if perineal trauma occurred.
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Metadata
Title
Incidence of perineal pain and dyspareunia following spontaneous vaginal birth: a systematic review and meta-analysis
Authors
Margarita Manresa
Ana Pereda
Eduardo Bataller
Carmen Terre-Rull
Khaled M. Ismail
Sara S. Webb
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 6/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-019-03894-0

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