Does episiotomy influence vaginal resting pressure, pelvic floor muscle strength and endurance, and prevalence of urinary incontinence 6 weeks postpartum?

Abstract

PFM function and/or prevalence of post-partum UI were not affected by a lateral or mediolateral episiotomy. Neurourol. Urodynam. 36:683-686, 2017. © 2016 Wiley Periodicals, Inc.

Impact of episiotomy on the urogenital hiatus using transperineal ultrasound

“…Therefore, in addition to a static assessment (ie, at rest) a dynamic or functional assessment measuring the hiatal area in contraction or on Valsalva, and the difference in the hiatus at rest and during contraction is also essential. Our ultrasound images showed that these variables were not affected, thus corroborating the results obtained by Bo et al in their assessment of vaginal resting pressure, pelvic floor muscle strength, and endurance in women with and without episiotomy . In any case, using only ultrasound variables we cannot state conclusively that the measurements of the urogenital hiatus are directly related to the muscle function of the levator ani.…”

“…The relation between episiotomy and pelvic floor dysfunction is not well known and the information regarding for example, its association with lesions of the anal sphincter or the presence of dyspareunia or perineal pain, is often contradictory. Five to 10 years after delivery Handa et al did not link episiotomy to pelvic floor dysfunction and Bo et al could found no differences in the incidence of stress incontinence in patients with or without episiotomy . Another study reported a higher incidence of incontinence associated with episiotomy, but their data were obtained from a survey with a low sample size which, as the authors noted, may well have affected the result.…”

Dynamic lumbopelvic stabilization for treatment of stress urinary incontinence in women: Controlled and randomized clinical trial

“…Stretches and ruptures of the pelvic floor during the passage of the fetus may compromise the neuronal response of these muscles, especially when there is a perineal lesion. In the present study, around one‐quarter of the sample reported injury to the perineum at vaginal delivery and approximately 50% reported episiotomy, although this alone is not related to SUI or to functional impairment of the pelvic floor . The use of forceps, reported by more than 25% of the sample, can also predispose to perineal lesions and compromise the mechanism of continence.…”

Força muscular do assoalho pélvico de primíparas segundo o tipo de parto: estudo de coorte

“…Pesquisa já citada na introdução, também não encontrou diferença, estatisticamente, significativa na função da FMAP (resistência, repouso e contração) entre as mulheres com ou sem episiotomia (Bø et al, 2017). Resultados opostos foram apontados na coorte que verificou, nas mulheres com episiotomia, valores de FMAP, estatisticamente, maiores comparadas àquelas sem esse procedimeto (Caroci et al, 2014).…”