Gün İsmet, Doğan Bülent, Özdamar Özkan
Gülhane Military Medical Academy, Haydarpaşa Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
İstanbul Medeniyet University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2016 Sep;13(3):144-148. doi: 10.4274/tjod.00087. Epub 2016 Sep 15.
Although extensively applied in obstetrics practice to facilitate delivery by increasing the vaginal birth conduit, most episiotomy studies are in the context of short- or medium-term outcomes, and the number of studies investigating the long-term effects is insufficient. Episiotomy is often considered associated with urinary and/or anal incontinence and dyspareunia; however, there is no concrete evidence for this issue. Current meta-analyses and reviews that assessed the studies available in the literature revealed that episiotomy does not decrease the rates of urinary incontinence, perineal pain, and sexual dysfunction and that routine episiotomy does not prevent pelvic floor damage; thus, the recommended use of mediolateral episiotomy is restricted, rather than routine. According to the limited number of studies on sexual function, there seems to be a linear relationship between the degree of perineal laceration and postpartum dyspareunia. It is still not clear whether episiotomy has any impact on pelvic floor relaxation, pelvic organ prolapse, and sexual dysfunction in the long term.
尽管会阴切开术在产科实践中被广泛应用，以通过增加阴道分娩通道来促进分娩，但大多数会阴切开术研究都是关于短期或中期结果的，而调查长期影响的研究数量不足。会阴切开术常被认为与尿失禁和/或肛门失禁以及性交困难有关；然而，关于这个问题并没有确凿的证据。目前评估文献中现有研究的荟萃分析和综述表明，会阴切开术并不会降低尿失禁、会阴疼痛和性功能障碍的发生率，并且常规会阴切开术并不能预防盆底损伤；因此，推荐使用的侧斜切开术受到限制，而非常规使用。根据关于性功能的有限研究数量，会阴裂伤程度与产后性交困难之间似乎存在线性关系。会阴切开术从长期来看是否会对盆底松弛、盆腔器官脱垂和性功能障碍产生任何影响仍不清楚。
