title: [Impact of pelvic floor muscle training on prevention of perineal pain and dyspareunia in postpartum].
abstract: OBJECTIVE
  Assessing the impact of perineal rehabilitation and massage on perineal pain and dyspareunia in the postpartum period, between 15days and 12months after delivery.
  
  
  METHODS
  We conducted an exhaustive review of the literature concerning pelvic floor rehabilitation in the postpartum between 1987 and May 2015, grading data by levels of evidence (LOE) according to the methodology recommendations for clinical guidelines.
  
  
  RESULTS
  Pelvic floor rehabilitation in the postpartum is not associated with a decreased prevalence of perineal pain and dyspareunia at 1year (LOE3). The practice of digital perineal massage during the third trimester of pregnancy is not associated with decreased prevalence at 3-month postpartum of perineal pain or dyspareunia (RR=0.64; 95% CI [0.39-1.08] and RR=0.96; 95% CI [0.84-1.08], respectively), except for women who have delivered vaginally (RR=0.45; 95% CI [0,24-0.87]) (LOE2). The practice of digital perineal massage or application of warm packs in the second stage of labor does not reduce perineal pain (RR=0.93; 95% CI [0.66-1.32]) or dyspareunia (RR=0.99; 95% CI [0.74-1.34]) at 3-month postpartum (LOE2).
  
  
  CONCLUSIONS
  There is no evidence of long-term benefit of perineal rehabilitation and perineal massage on perineal pain and dyspareunia in the year following childbirth. Further studies are needed to accurately assess the impact of therapeutic strategies proposed in France.
authors.affiliation: Cabinet de sage-femme et rééducation périnéale, 68, rue des Prairies, 75020 Paris, France. Electronic address: anne.battut@hotmail.fr.
authors.forename: A
authors.initials: A
authors.lastname: Battut
authors.affiliation: Service de gynécologie-obstétrique, groupe hospitalier de la Pitié-Salpêtrière, AP-HP, Sorbonne universités, université Paris 06, CNRS UMR 7222, inserm U1150, 75013 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Nizard
mesh_terms: D004414:Dyspareunia / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D010146:Pain / Q000517:prevention & control*; D017773:Pelvic Floor; D010502:Perineum; D011644:Puerperal Disorders / Q000517:prevention & control*
keywords: Douleurs périnéales; Dyspareunia; Dyspareunies; Fonction sexuelle; Massages périnéaux; Perineal massage; Perineal pain; Perineal rehabilitation; Post-partum; Postpartum; Prevention; Prévention; Rééducation périnéale; Sexual function