title: Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy.
abstract: OBJECTIVE
  To evaluate short-term perineal pain among primiparous women after mediolateral episiotomy (MLE) and lateral episiotomy (LE).
  
  
  METHODS
  The prospective randomized study was conducted in the Czech Republic during 2010-2012. Consecutive primiparous women who gave birth at or after 37 weeks of pregnancy and had indications for an episiotomy were enrolled and randomly assigned to undergo MLE or LE. Patients were unaware of the episiotomy type performed. The primary outcomes were pain at 24 hours, 72 hours, and 10 days post partum, measured by a visual analog scale, verbal rating scale, interference with activities of daily living, and amount of analgesic use.
  
  
  RESULTS
  The analysis included 266 women who underwent MLE and 297 women who underwent LE. Complete relief of pain was observed in 6 (2.3%) of 266 women after 24 hours, 21 (8.0%) of 264 after 72 hours, and 77 (29.1%) of 265 after 10 days in the MLE group, and in 11 (3.9%) of 285, 23 (7.7%) of 297, and 78 (26.4%) of 295 in the LE group, respectively (P=0.36). There were no significant differences in overall pain scores from any rating system or in the amount of analgesics used.
  
  
  CONCLUSIONS
  Incidence and extent of pain in the first 10 days after LE correspond to those after adequately performed MLE.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Karbanova
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rusavy
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
authors.forename: Lucie
authors.initials: L
authors.lastname: Betincova
authors.affiliation: New Technologies for the Information Society, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Jansova
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
authors.forename: Pavlina
authors.initials: P
authors.lastname: Necesalova
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic. Electronic address: kalisv@fnplzen.cz.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kalis
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D004841:Episiotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D010147:Pain Measurement; D049590:Postpartum Period; D011247:Pregnancy; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics
keywords: Lateral episiotomy; Mediolateral episiotomy; Pain; Painful defecation; Visual analog scale; Wound healing