[Immediate and long term complications of episiotomy].
OBJECTIVE
The objective of this review was to describe the complications of episiotomy.


METHODS
A systematic review on Medline Database set was performed with the key words: episiotomy, dyspareunia, fecal incontinence, urinary incontinence, maternal morbidity, pelvic floor defects and sexual function. Four hundred seventy two articles were selected.


RESULTS
When performed liberally, episiotomy appears to increase the risk of post partum bleeding. More restrictive use does not appear to increase the risk of serious perineal injury. In the event of instrumental extraction, use of episiotomy appears to be associated with more severe damage. Medial episiotomy does not appear to be associated with third or fourth degree tears. Following delivery, patients who had an episiotomy complain of perineal pain more than those with an intact perineum or first or second degree tears. Three months after delivery, there is no difference. While episiotomy appears to be a source of dyspareunia during the first weeks after delivery in comparison with spontaneous tears, this does not appear to be true later after delivery.


CONCLUSIONS
Episiotomy appears to be the cause of more perineal pain and dyspareunia during the early post partum weeks.
Département de Gynécologie-Obstétrique, Hôpital de Hautepierre, avenue Molière, 67098 Strasbourg Cedex. Bruno.Langer@chru-strasbourg.fr
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B
Langer
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A
Minetti
D000328:Adult; D004414:Dyspareunia / Q000453:epidemiology; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010149:Postoperative Pain / Q000453:epidemiology*; D017773:Pelvic Floor / Q000503:physiopathology; D010502:Perineum / Q000293:injuries* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D013997:Time Factors; D014549:Urinary Incontinence / Q000453:epidemiology