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Open Access Highly Accessed Research article

Impact of episiotomy on pelvic floor disorders and their influence on women's wellness after the sixth month postpartum: a retrospective study

Serena Bertozzi1, Ambrogio P Londero2*, Arrigo Fruscalzo3, Lorenza Driul2, Cristina Delneri4, Angelo Calcagno2, Paolo Di Benedetto4 and Diego Marchesoni2

Author Affiliations

1 Clinic of Surgical Semeiotics, AOU "SM della Misericordia" of Udine, 33100 Udine Italy

2 Clinic of Obstetrics and Gynecology, AOU "SM della Misericordia" of Udine, 33100 Udine Italy

3 Frauenklinik, Mathias-Spital, Frankenburgstr. 31, 48431 Rheine, Germany

4 Istituto di Medicina Fisica e Riabilitazione Gervasutta, Dipartimento di Medicina Riabilitativa, servizo di Diagnosi e Riabilitazione Perineale, 33100 Udine, Italy

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BMC Women's Health 2011, 11:12  doi:10.1186/1472-6874-11-12

Published: 18 April 2011

Abstract

Background

The role of episiotomy as a protective factor against pelvic floor disorders postpartum has been debated for many years, but its routine use has been hitherto discouraged in the literature. Comparisons between restrictive and routine use of episiotomy in existent literature, however, fail to include any consideration relating to quality of life. The aim of this study, therefore, is to state the role of episiotomy in preserving the perineum from damage, in order to prevent the influence of pelvic floor disorders on women's psycho-physical wellness after the sixth month postpartum.

Methods

A follow-up telephone interview was performed among 377 primiparous and secondiparous Caucasian women who had a child by spontaneous or operative vaginal delivery in 2006 using a self-created questionnaire and King's Health Questionnaire (KHQ).

Results

The mean age at delivery was 35.26 (±4.68) years and episiotomy was performed in 59.2% of women. Multivariate linear regression shows episiotomy associated to higher quality of life after the sixth month postpartum by correlating with inferior values of King's Health Questionnaire (p < 0.05).

Conclusions

Episiotomy appears to be a protective factor for women's wellness. Women who had episiotomy and who experienced perineal symptoms have a better psycho-physical health status in the 12.79 months (±3.3) follow-up.

Keywords:
episiotomy; vaginal delivery; pelvic floor disorders; perineum; psycho-physical health