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BMC Women's Health
Published in: BMC Women's Health 1/2014

Open Access 01-12-2014 | Research article

Anal incontinence, urinary incontinence and sexual problems in primiparous women – a comparison between women with episiotomy only and women with episiotomy and obstetric anal sphincter injury

Authors: Mona Stedenfeldt, Jouko Pirhonen, Ellen Blix, Tom Wilsgaard, Barthold Vonen, Pål Øian

Published in: BMC Women's Health | Issue 1/2014

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Abstract

Background

Obstetric anal sphincter injuries (OASIS) might cause anal incontinence (AI) and sexual dysfunction, and might be associated with urinary incontinence (UI). Episiotomy has been identified both as a risk and a protective factor of OASIS. Lately, episiotomies with specific characteristics have shown to be protective against the risk of OASIS. However, little is known about episiotomy characteristics and pelvic floor dysfunction. This study investigates AI, UI, and sexual problems in primiparous women with episiotomy, comparing women with and without OASIS. Associations between episiotomy characteristics and AI, UI, and sexual problems were assessed.

Methods

This is a matched case–control study investigating 74 women with one vaginal birth, all with an episiotomy. Among these, 37 women sustained OASIS and were compared to 37 women without OASIS. The two groups were matched for vacuum/forceps. AI, UI and sexual problem symptoms were obtained from St. Mark’s scoring-tool and self-administered questionnaires. The episiotomy characteristics were investigated and results assessed for the whole group.

Results

The mean time from birth was 34.5 months (range1.3-78.2) for those with OASIS and 25.9 months (range 7.0-57.4) for those without OASIS, respectively. More women with OASIS reported AI: 14 (38%) vs. 3 (8%) p = 0.05 (OR 4.66, 95% CI 1.34-16.33) as well as more problem with sexual desire p = 0.02 (OR 7.62, 95% CI 1.30-44.64) compared to women without OASIS. We found no association between episiotomy with protective characteristics and dysfunctions.

Conclusion

Women with OASIS had more AI and sexual problems than those without OASIS. Episiotomy characteristics varied greatly between the women. Episiotomy with protective characteristics was not associated with increased dysfunctions. OASIS should be avoided, and correct episiotomy used if indicated.
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Metadata
Title
Anal incontinence, urinary incontinence and sexual problems in primiparous women – a comparison between women with episiotomy only and women with episiotomy and obstetric anal sphincter injury
Authors
Mona Stedenfeldt
Jouko Pirhonen
Ellen Blix
Tom Wilsgaard
Barthold Vonen
Pål Øian
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2014
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-014-0157-y

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