Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, Burhanettin Ustunel C., No:20, Uskudar, 34668 Istanbul, Turkey.
Arch Gynecol Obstet. 2012 Feb;285(2):411-5. doi: 10.1007/s00404-011-1965-z. Epub 2011 Jul 7.
This retrospective study investigates the effects of mediolateral episiotomy on the pelvic floor.
Premenopausal women suffering from urinary incontinence/genital prolapse who delivered only by vaginal route were enrolled into the study. History of diabetes, morbid obesity (BMI > 40 kg/m(2)), vacuum/forceps extraction, perineal lacerations that warranted repair during labor and any pelvic surgery were the exclusion criteria. Evaluation of the patients included pelvic organ prolapse quantification scores, presence of stress incontinence, urethral hypermobility, and questionnaires were obtained for overactive bladder and anal incontinence symptoms. These data obtained from patients with the history of mediolateral episiotomy were compared with those of patients with no episiotomy or any other pelvic injury that warranted surgical repair.
Groups were identical by means of demographic data, POP-Q findings, signs and symptoms of the pelvic floor. However, in the MLE group, central defects on the anterior vaginal wall were less frequent.
According to the results of this retrospective study, MLE seems to prevent central defects on the anterior vaginal wall. Prospective randomized studies are needed to draw a sufficient conclusion.
本回顾性研究旨在探讨会阴正中切开术对盆底的影响。
本研究纳入了仅经阴道分娩且患有尿失禁/阴道前壁膨出的绝经前女性。患有糖尿病、病态肥胖（BMI＞40kg/m²）、真空吸引/产钳助产、分娩时需要会阴裂伤修补以及任何盆腔手术史的患者被排除在外。对患者进行评估，包括盆腔器官脱垂定量评分、压力性尿失禁、尿道过度活动以及膀胱过度活动症和肛门失禁症状的问卷。将有会阴正中切开术史患者的数据与无会阴切开术或任何其他需要手术修复的骨盆损伤患者的数据进行比较。
两组在人口统计学数据、POP-Q 发现、盆底的体征和症状方面均无差异。然而，在 MLE 组中，前阴道壁中央缺陷较少。
根据本回顾性研究的结果，会阴正中切开术似乎可以预防前阴道壁中央缺陷。需要前瞻性随机研究来得出充分的结论。
