Does episiotomy influence vaginal resting pressure, pelvic floor muscle strength and endurance, and prevalence of urinary incontinence 6 weeks postpartum?

Abstract

The aim of the present study was to compare vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and endurance, and prevalence of urinary incontinence (UI) at 6 weeks postpartum, in women with and without lateral or mediolateral episiotomy. Two hundred and thirty-eight nulliparous pregnant women, mean age 28.5 years (SD 4.2) and pre-pregnancy BMI 23.8 (SD 4.0) participated in the study. Lateral or mediolateral episiotomy was only performed for indications such as fetal distress or imminent risk of severe perineal tear. At 6 weeks postpartum, a vaginal balloon connected to a high precision pressure transducer was used to measure VRP (cm H2 O), PFM strength (cm H2 O), and endurance (cm H2 O sec). All women completed the International Classification of Urinary Incontinence Short Form (ICIQ-UI-SF) by means of an electronic questionnaire. No statistically significant differences were found in VRP (mean difference 0.0 cm H2 O, 95%CI: -2.1 to 2.1), PFM strength (mean difference 1.3 cm H2 O, 95%CI: -1.9 to 4.6), or PFM endurance (mean difference 12.1 cm H2 O sec, 95%CI: -11.0 to 35.1) between women with or without episiotomy. No significant differences were found in prevalence of UI (37.5% vs. 46.6%) or SUI (23.6% vs. 35.6%), between women with or without episiotomy, respectively. PFM function and/or prevalence of post-partum UI were not affected by a lateral or mediolateral episiotomy. Neurourol. Urodynam. 36:683-686, 2017. © 2016 Wiley Periodicals, Inc.