To cut or not to cut, that is the question: A review of the anatomy, the technique, risks, and benefits of an episiotomy

Abstract

Childbirth can be a traumatic experience on the female body. Some techniques may be implemented to make the process smoother and decrease the potential lacerations that can occur. Episiotomies have been used by obstetricians and midwives to help make the fetal decent down the vaginal canal less turbulent. A physician must use his best judgment on when it is necessary to make this incision and what form of incision to make. Before making an incision one must understand the female external and internal anatomy and thoroughly comprehend the stages of birth to understand how and what complications can occur. Even though an episiotomy is a minor incision, it is still a surgical incision nonetheless and as with any form of surgery there are both risks and benefits that are to be considered. Nevertheless, episiotomies have proven to help ease births that are complicated by shoulder dystocia, prevent severe lacerations, and decrease the second stage of labor. The following comprehensive review provides a description of the female anatomy, as well as an extensive description of why, when, and how an episiotomy is done. Clin. Anat. 30:362-372, 2017. © 2017 Wiley Periodicals, Inc.

Spatial distribution of smooth muscle tissue in the male pelvic floor with special reference to the lateral extent of the rectourethralis muscle: Application to prostatectomy and proctectomy

“…The term “perineal body” is often used to describe the anatomy of the pelvic floor and perineal region (Plochocki et al, ; Muhleman et al, ). However, we did not use this term to describe the results of our study, because we believe that using “perineal body” for referring to a specific structure is not appropriate.…”

Effect of type of birth on the health of mother and newborn

“…Epizyotomi Epizyotomi sıklıkla fetal hipoksinin önlenmesi, doğumun ikinci evresinin süresinin kısaltılması, anal sfinkterin korunması, laserasyonların ve doğum sonrası pelvis ve perine problemlerinin önlenmesi gibi amaçlarla perine kaslarına uygulanan bir müdahale yöntemidir (31,32). Ancak aksine literatürde epizyotominin kısa vadede perineal travmalara, üçüncü ve dördüncü derece laserasyonlara (33,34), cinsel işlev bozukluklarına, pelvik ağrıya, kan kaybına, enfeksiyona, disparoniye, üriner ve anal inkontinansa (35,36,37) neden olduğunu gösteren çalışmalar da bulunmaktadır. Yani epizyotominin, laserasyonları önlediğini belirten çalışmalar olsa da rutin epizyotominin laserasyonları azalttığına dair açık bir kanıt yoktur.…”

“…Sonuç olarak rutin epizyotomi önerilmemektedir. Çocuk sağlığı açısından; epizyotominin serebral hemoraji, serebral palsi ve mental retardasyon gibi yenidoğana ait travmaları önlediği belirtilse de; intraventriküler kanama ve omuz distosisi gibi faktörleri etkilemediği belirlenmiştir (37). Oksitosin Uygulaması Oksitosin, doğum eylemini hızlandırma ve başlatmada en yaygın kullanılan maddelerdendir.…”

Anatomical complications of hysterectomy: A review

“…Abdominal and vaginal hysterectomy is associated with an increased risk of mild rectal incontinence symptoms. Patients with a reported history of obstetric sphincter injury are at particular risk for posthysterectomy fecal incontinence (Muhleman et al, ). Greater age at the time of surgery is also associated with a higher risk of anal incontinence.…”