OBJECTIVE: To study the angle of mediolateral episiotomy at the time of cut, after primary repair, and 6 months postpartum; and the incidence and severity of perineal pain and anal incontinence 6 months after delivery. METHODS: The study group comprised 60 consecutively recruited primiparous women who required episiotomy during delivery assisted by 2 obstetricians. The incision angle of episiotomy (defined as 60°) was measured before cutting, after primary repair, and after 6 months. At follow-up, perineal pain was evaluated by a verbal rating score; anal incontinence was assessed by St Mark's score. RESULTS: The angles differed significantly among the incision (60°), repair (45°), and 6-month (48°) measurements (P < 0.001). There was a poor correlation between the suture angle and the angle measured at 6 months postpartum. No severe perineal tear was diagnosed in the cohort. At 6 months postpartum, only 1 woman reported mild symptoms of de novo anal incontinence, whereas 7 women reported perineal pain related to episiotomy. CONCLUSION: An incision angle of mediolateral episiotomy of 60° resulted in a low incidence of anal sphincter tearing, anal incontinence and perineal pain. A randomized controlled trial is needed to assess the outcome when different angles of episiotomy are used.
OBJECTIVE: To study the angle of mediolateral episiotomy at the time of cut, after primary repair, and 6 months postpartum; and the incidence and severity of perineal pain and anal incontinence 6 months after delivery. METHODS: The study group comprised 60 consecutively recruited primiparous women who required episiotomy during delivery assisted by 2 obstetricians. The incision angle of episiotomy (defined as 60°) was measured before cutting, after primary repair, and after 6 months. At follow-up, perineal pain was evaluated by a verbal rating score; anal incontinence was assessed by St Mark's score. RESULTS: The angles differed significantly among the incision (60°), repair (45°), and 6-month (48°) measurements (P < 0.001). There was a poor correlation between the suture angle and the angle measured at 6 months postpartum. No severe perineal tear was diagnosed in the cohort. At 6 months postpartum, only 1 woman reported mild symptoms of de novo anal incontinence, whereas 7 women reported perineal pain related to episiotomy. CONCLUSION: An incision angle of mediolateral episiotomy of 60° resulted in a low incidence of anal sphincter tearing, anal incontinence and perineal pain. A randomized controlled trial is needed to assess the outcome when different angles of episiotomy are used.
Authors: Hadil Y Ali-Masri; Sahar J Hassan; Kaled M Zimmo; Mohammed W Zimmo; Khaled M K Ismail; Erik Fosse; Hasan Alsalman; Åse Vikanes; Katariina Laine Journal: Obstet Gynecol Int Date: 2018-10-29
Authors: Madhu Naidu; Dharmesh S Kapoor; Sarah Evans; Latha Vinayakarao; Ranee Thakar; Abdul H Sultan Journal: Int Urogynecol J Date: 2015-02-06 Impact factor: 2.894
Authors: Shimon Ginath; Osnat Elyashiv; Eran Weiner; Ron Sagiv; Jacob Bar; Joseph Menczer; Michal Kovo; Alexander Condrea Journal: Int Urogynecol J Date: 2017-05-05 Impact factor: 2.894
Authors: Margarita Manresa; Ana Pereda; Eduardo Bataller; Carmen Terre-Rull; Khaled M Ismail; Sara S Webb Journal: Int Urogynecol J Date: 2019-02-15 Impact factor: 2.894