Anal incontinence and fecal urgency following vaginal delivery with episiotomy among primiparous patients.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: United States NLM ID: 0210174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-3479 (Electronic) Linking ISSN: 00207292 NLM ISO Abbreviation: Int J Gynaecol Obstet Subsets: MEDLINE
    • Publication Information:
      Publication: 2017- : Malden, MA : Wiley
      Original Publication: [New York, NY] Hoeber Medical Division, Harper & Row, [c1969-
    • Subject Terms:
      Episiotomy/*adverse effects ; Fecal Incontinence/*epidemiology ; Obstetric Labor Complications/*epidemiology ; Perineum/*surgery; Adult ; Czech Republic ; Fecal Incontinence/etiology ; Female ; Follow-Up Studies ; Humans ; Parity ; Postpartum Period ; Pregnancy ; Prospective Studies ; Surveys and Questionnaires ; Young Adult
    • Abstract:
      Objective: To investigate anal incontinence following mediolateral or lateral episiotomy during a first vaginal delivery.
      Methods: The present prospective follow-up study enrolled primiparous patients who underwent vaginal delivery including mediolateral or lateral episiotomy between April 1, 2010 and March 31, 2012. Participants completed interviews before delivery, and were given anal-incontinence questionnaires to be returned for analysis at 3 months and 6 months postpartum. Anal incontinence was defined as a St Mark's incontinence score above four and individual anal-incontinence components were analyzed separately; results were compared between the two episiotomy techniques.
      Results: Questionnaires were returned by 300 and 366 patients who underwent mediolateral and lateral episiotomies, respectively; baseline characteristics were similar. Anal incontinence at 3 months and 6 months was recorded among 21 (7.0%) and 9 (3.0%) patients who underwent mediolateral and 27 (7.4%) and 20 (5.5%) who underwent lateral episiotomy, respectively. The study was underpowered to confirm equivalence between the groups; however, no statistically significant differences were observed in the rates of anal incontinence, flatus, solid or liquid incontinence, and de novo incontinence. Fecal urgency (P=0.017) and de novo fecal urgency (P=0.008) were more prevalent among patients who underwent lateral episiotomies at 6 months.
      Conclusion: Anal incontinence was comparable between primiparous patients who underwent mediolateral or lateral episiotomy. The association between lateral episiotomy and fecal urgency merits further scientific interest.
      (Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)
    • Contributed Indexing:
      Keywords: Anal incontinence; Childbirth; Episiotomy; Fecal urgency; Vaginal delivery
    • Publication Date:
      Date Created: 20160920 Date Completed: 20170516 Latest Revision: 20170516
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.ijgo.2016.06.025
    • Accession Number:
      27641426