Long-term impacts of vaginal birth with mediolateral episiotomy on sexual and pelvic dysfunction and perineal pain.
OBJECTIVE
To investigate whether spontaneous vaginal birth with mediolateral episiotomy has any long-term impact on urinary and/or fecal incontinence, sexual dysfunction and perineal pain in primiparous women.


METHODS
This matched case-control study included 150 women between 25 and 35 years old who had a singleton childbirth at least five years previously. Patients were grouped as; women who had a spontaneous vaginal delivery with mediolateral episiotomy (Group 1), an elective cesarean delivery (Group 2), and who had no delivery (Group 3). Controls were matched for age and delivery time. Urinary/fecal incontinence were questioned and Female Sexual Function Index (FSFI) questionnaire was completed. Total FSFI and domain scores were compared. Statistical evaluation was performed using One-way ANOVA test or χ2test. Statistical significance was defined as p < 0.05.


RESULTS
No women had urinary/fecal incontinence nor sexual dysfunction. Mean total FSFI points in Group 1 were significantly lower than in Groups 2 and 3 (p = 0.001). There were significant differences in sexual desire between groups 1 and 3 (p = 0.005), in arousal and in orgasm between both groups 1 and 2 (p = 0.001 and p = 0.038, respectively) and groups 1 and 3 (p = 0.001 and p = 0.001, respectively). There was no significant difference between groups 2 and 3 in any parameters or total points.


CONCLUSIONS
Vaginal delivery with mediolateral episiotomy is not associated with urinary and/or fecal incontinence and sexual dysfunction but associated with a decreased sexual functioning as well as sexual desire, arousal and orgasm within postpartum five years.
a Department of Obstetrics and Gynecology , GATA Haydarpaşa Training and Educational Hospital , Istanbul , Turkey and.
Bülent
B
Doğan
a Department of Obstetrics and Gynecology , GATA Haydarpaşa Training and Educational Hospital , Istanbul , Turkey and.
İsmet
İ
Gün
b Department of Obstetrics and Gynecology , Istanbul Medeniyet University, Faculty of Medicine, Istanbul , Turkey.
Özkan
Ö
Özdamar
a Department of Obstetrics and Gynecology , GATA Haydarpaşa Training and Educational Hospital , Istanbul , Turkey and.
Ali
A
Yılmaz
a Department of Obstetrics and Gynecology , GATA Haydarpaşa Training and Educational Hospital , Istanbul , Turkey and.
Murat
M
Muhçu
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods*; D004841:Episiotomy / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D007989:Libido; D010146:Pain / Q000209:etiology; D010502:Perineum / Q000503:physiopathology; D011247:Pregnancy; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology
Female sexual function index; mediolateral episitotomy; perineal pain; sexual function; vaginal delivery