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Background: High prevalence of urinary incontinence in women is a worldwide problem. Higher incidence of problems with urinary incontinence was observed in women after childbirth. Some studies have found a connection between urinary incontinence and perineal trauma. Aim: To determine the influence of perineal trauma (episiotomy, spontaneous rupture) on the pelvic floor and urinary incontinence. Methods: In search for sources we used the electronic databases Medline, CINAHL, PubMed, Science Direct, Scopus, Medvik, and the electronic search engines Google and Google Scholar. We searched for articles in Czech or English. The following keywords were used: perineal trauma, episiotomy, childbirth, urinary incontinence. A total of 21 studies were found: 1 meta-analysis, 3 systematic reviews, 2 randomized controlled trials, and 15 cohort studies. Results: Women with an intact perineum had a stronger pelvic floor than women with a perineal injury, although they did not differ significantly in the incidence of urinary incontinence. A relationship between urinary incontinence and the extent of a spontaneous injury has not been proved. Episiotomy does not protect the pelvic floor and does not reduce the incidence of urinary incontinence in women after childbirth. Conclusion: Obstetricians and midwives should maximally reduce perineal injuries. No study has yet proven a positive effect of episiotomy on the pelvic floor and a reduction in the incidence of urinary incontinence, therefore episiotomy should be performed in clinical practice only when medically indicated. KLÍČOVÁ SLOVA porodní poranění, epiziotomie, močová inkontinence, porod, pánevní dno

Perineal trauma and its effect on the pelvic floor and urinary incontinence