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Anal incontinence, urinary incontinence and sexual problems in primiparous women – a comparison between women with episiotomy only and women with episiotomy and obstetric anal sphincter injury

Stedenfeldt, Mona; Pirhonen, Jouko; Blix, Ellen; Wilsgaard, Tom; Vonen, Barthold; Øian, Pål
Journal article, Peer reviewed
© 2014 stedenfeldt et al.; licensee bio med central. this is an open access article distributed under the terms of the creative commons attribution license (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. the creative commons public domain dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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URI
https://hdl.handle.net/10642/2425
Date
2014
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  • HV - Institutt for sykepleie og helsefremmende arbeid [1575]
Original version
Stedenfeldt, M., Pirhonen, J., Blix, E., Wilsgaard, T., Vonen, B. & Øyan, P. (2014). Anal incontinence, urinary incontinence and sexual problems in primiparous women - a comparison between women with episiotomy only and women with episiotomy and obstetric anal sphincter injury. BMC Women's Health, 14(157). doi:10.1186/s12905-014-0157-y   http://dx.doi.org/10.1186/s12905-014-0157-y
Abstract
Background: Obstetric anal sphincter injuries (OASIS) might cause anal incontinence (AI) and sexual dysfunction,

and might be associated with urinary incontinence (UI). Episiotomy has been identified both as a risk and a

protective factor of OASIS. Lately, episiotomies with specific characteristics have shown to be protective against the

risk of OASIS. However, little is known about episiotomy characteristics and pelvic floor dysfunction. This study

investigates AI, UI, and sexual problems in primiparous women with episiotomy, comparing women with and

without OASIS. Associations between episiotomy characteristics and AI, UI, and sexual problems were assessed.

Methods: This is a matched case–control study investigating 74 women with one vaginal birth, all with an

episiotomy. Among these, 37 women sustained OASIS and were compared to 37 women without OASIS. The two

groups were matched for vacuum/forceps. AI, UI and sexual problem symptoms were obtained from St. Mark’s

scoring-tool and self-administered questionnaires. The episiotomy characteristics were investigated and results

assessed for the whole group.

Results: The mean time from birth was 34.5 months (range1.3-78.2) for those with OASIS and 25.9 months (range

7.0-57.4) for those without OASIS, respectively. More women with OASIS reported AI: 14 (38%) vs. 3 (8%) p = 0.05

(OR 4.66, 95% CI 1.34-16.33) as well as more problem with sexual desire p = 0.02 (OR 7.62, 95% CI 1.30-44.64)

compared to women without OASIS. We found no association between episiotomy with protective characteristics

and dysfunctions.

Conclusion: Women with OASIS had more AI and sexual problems than those without OASIS. Episiotomy

characteristics varied greatly between the women. Episiotomy with protective characteristics was not associated

with increased dysfunctions. OASIS should be avoided, and correct episiotomy used if indicated.
Publisher
BioMed Central
Series
BMC Women's Health;14(157)

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