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Archives of Gynecology and Obstetrics

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01-02-2019 | Review

Long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse: a systematic review

Authors: Matteo Frigerio, Salvatore A. Mastrolia, Federico Spelzini, Stefano Manodoro, David Yohay, Adi Y. Weintraub

Published in: Archives of Gynecology and Obstetrics | Issue 2/2019

Abstract

Purpose

To focus attention on the long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse.

Methods

A systematic review was conducted including only studies with mean follow-up ≥ 5 years. We searched using combinations of the following keywords and text words: “episiotomy”, “perineal laceration”, “perineal tear”, “perineal damage” and “long term”, “long term outcomes”, “prolapse”, “pelvic organ prolapse”, “pelvic floor”, “pelvic floor dysfunction”, “urinary incontinence”, “hysterocele”, “cystocele” and “rectocele”.

Results

The electronic database search provided a total of 6154 results. After exclusions, 24 studies were included yielding the following results: (1) episiotomy might be detrimental with respect to urinary incontinence symptoms; (2) the relationship between episiotomy and anti-incontinence surgery is not clear; (3) episiotomy does not seem to negatively influence genital prolapse development and might even be protective with respect to prolapse severity and prevalence; (4) episiotomy does not seem to affect genital prolapse surgery rate.

Conclusions

We did not find evidence for a long-term beneficial effect of episiotomy in the prevention of urinary incontinence symptoms and anti-incontinence surgery. Episiotomy does not seem to negatively influence genital prolapse development and might even be protective with respect to prolapse severity and prevalence without affecting surgery rates.

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Title: Long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse: a systematic review
Authors: Matteo Frigerio
Salvatore A. Mastrolia
Federico Spelzini
Stefano Manodoro
David Yohay
Adi Y. Weintraub
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-5009-9

At a glance: The STEP trials

Springer Medicine

Long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse: a systematic review

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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