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Published in: BMC Women's Health 1/2024

Open Access 01-12-2024 | Perineal Laceration | Research

Pelvic floor function after third and fourth degree perineal lacerations: a case-control study on quality of life

Authors: Andrea Sartore, Maria Sole Scalia, Francesco Paolo Mangino, Giulia Savastano, Elena Magni, Giuseppe Ricci

Published in: BMC Women's Health | Issue 1/2024

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Abstract

Background

The primary aim of this study was to compare the quality of life between women with obstetric anal sphincter injury (OASI) and women with intact perineum or minor vaginal tears following their first vaginal birth through a validated urogynaecological questionnaire. As a secondary aim, we wanted to identify the specific symptoms for pelvic floor dysfunction after a vaginal birth.

Methods

One hundred thirty-three cases (III- and IV-degree vaginal tears) and 133 controls (intact perineum or I- and II-degree vaginal tear) were asked to fill the PFDI-20 condition-specific and quality of life survey at three and 12 months after vaginal delivery. The survey evaluates pelvic floor dysfunction symptoms through three subsections: the Pelvic Organ Prolapse Distress Inventory (POPDI), the Colorectal-Anal Distress Inventory (CRADI), and Urinary Distress Inventory, (UDI). The scoring system ranges from 0 (no distress) to 100 (maximum distress) for each subsection, subsequently summed up to obtain the summary score (0 to 300). The patients recruited were asked to complete the survey at 3- and 12-months follow-up visit. Accordingly, data collection started. Categorical variables were subjected to Chi-square test or Fisher’s Exact test. Quantitative variables were compared through Student’s t-test or Mann-Whitney test.

Results

All surveys have shown statistically significant differences when comparing the cases to the control group. Consequently, PFDI-20 has shown a strong correlation between III- and IV-grade lacerations and pelvic floor dysfunction persistence at 12 months after delivery. Intestinal symptoms were the most reported disturbances among women with previous OASI.

Conclusions

Major vaginal tears have demonstrated to have a strong impact on women’s quality of life up to a follow-up of 12 months. The use of PFDI-20 questionnaire is a useful and valid tool in the diagnosis and follow-up of genital prolapse, fecal and urinary incontinence in primiparous women with a history of OASI. Thus, its application in clinical practice can help offering the most adequate rehabilitative treatment.
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Metadata
Title
Pelvic floor function after third and fourth degree perineal lacerations: a case-control study on quality of life
Authors
Andrea Sartore
Maria Sole Scalia
Francesco Paolo Mangino
Giulia Savastano
Elena Magni
Giuseppe Ricci
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2024
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-023-02739-9

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