eISSN: 2299-0038
ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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abstract:
Original paper

Effects of lateral episiotomy on the emergence of urinary incontinence during the first postpartum year in primiparas: prospective cohort study

Krešimir Živković
1
,
Slavko Orešković
2
,
Anis Cerovac
3
,
Milan Milošević
4
,
 Ana Tikvica Luetić
5
,
Matija Prka
1
,
Dubravko Habek
1
,
David Lukanović
6
,
Giulia Spagnol
7
,
Nikica Živković
8

1.
Department of Obstetrics and Gynecology, “Sveti Duh” University Hospital, University of Zagreb, School of Medicine, Zagreb, Croatia
2.
Department of Obstetrics and Gynecology, Zagreb University Hospital Center, University of Zagreb, School of Medicine, Zagreb, Croatia
3.
Department of Obstetrics and Gynecology, Tešanj General Hospital, School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
4.
Andija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
5.
Department of Obstetrics and Gynecology,”Sveti Duh” University Hospital, Catholic University of Croatia, Zagreb, Croatia
6.
Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
7.
Department of Women and Children’s Health, Clinic of Gynaecology and Obstetrics, University of Padua, Padua, Italy
8.
Department of Obstetrics and Gynecology, Šibenik General Hospital, Šibenik, Croatia
Menopause Rev 2021; 20(4)
Online publish date: 2021/11/23
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Introduction
Lateral episiotomy is a widely used procedure, although it is rarely mentioned in theliterature and its effects on the pelvic floor are largely unexplored. The purpose of this study is to evaluate the impact of lateral episiotomy on the incidence of urinary incontinence (UI) after vaginal delivery in primiparas.

Material and methods
The study design is a prospective cohort study. The primiparas were divided into two groups. The first group consisted of women who gave birth with lateral episiotomy, while the second group included women who gave birth with an intact perineum or with perineal tears of first and second degree. Assessments of UI were performed at 5 and 8 months after childbirth using the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) questionnaire followed by the stress test.

Results
The results revealed no significant differences (p > 0.05) in emergence of stress urinary incontinence (SUI) between the groups at the two time points. There were no statistically significant differences in overall rate of UI, urge urinary incontinence (UUI), or mixed urinary incontinence according to the ICIQ-SF questionnaire. The overall incontinence rate on the first examination was 24% in the episiotomy group and 36% in the perineal laceration group, although the difference was not statistically significant (p = 0.064). On the second examination, rates were similar and without a statistically significant difference.

Conclusions
Lateral episiotomy has a neutral effect on the onset of UI in primiparous women in the first year after delivery.

keywords:

episiotomy, urinary incontinence, primiparas

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