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Anal incontinence and fecal urgency following vaginal delivery with episiotomy among primiparous patients
Author(s) -
Rusavy Zdenek,
Karbanova Jaroslava,
Jansova Magdalena,
Kalis Vladimir
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.06.025
Subject(s) - medicine , episiotomy , fecal incontinence , vaginal delivery , pelvic floor , obstetrics , gynecology , surgery , pregnancy , genetics , biology
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.