Bonasia Kyra, Luong Susan, Stairs Jocelyn, Clancy Aisling
Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.
Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Canada.
Int Urogynecol J. 2025 Mar;36(3):677-684. doi: 10.1007/s00192-025-06077-2. Epub 2025 Jan 31.
Obstetric anal sphincter injuries (OASI) are associated with significant risk of complications, including pain, infection, and long-term pelvic floor dysfunction. The primary aim of this study was to evaluate the utility and acceptability of a postpartum telehealth consultation focused on pelvic floor health for patients after OASI.
This prospective study used a pre-post design comparing standard postpartum care versus standard postpartum care plus a telehealth urogynecology consultation focused on pelvic floor recovery. The primary outcome was symptom burden as measured by the Pelvic Floor Distress Inventory (PFDI-20) score 16-weeks postpartum. Patient experience was evaluated using the QQ10 and the Patient Enablement Instrument. T-tests and chi-squared tests were used to compare groups.
A total of 119 participants completed study activities (control group n = 62, intervention group n = 57). There was no significant difference between the two groups in PFDI-20 scores (55.6 versus 46.6, p = 0.23). The individual items most likely to be endorsed among all participants were related to flatal incontinence (52.1%) and fecal urgency (49.6%). For the subset analysis of 35 patients with severe OASI (3C or fourth-degree tears), those who had a telehealth consultation had lower PFDI-20 scores (56.6 versus 34.7; p = 0.04). QQ10 estimated a value score of 79/100 and a burden score of 18/100 for the telehealth consultation.
A postpartum telehealth consultation focused on pelvic floor health may benefit patients with severe OASI who reported reduced symptom burden. Participants rated a telehealth consultation as high value and low burden for this condition.
产科肛门括约肌损伤（OASI）与包括疼痛、感染和长期盆底功能障碍在内的严重并发症风险相关。本研究的主要目的是评估针对OASI患者的产后远程医疗咨询在盆底健康方面的实用性和可接受性。
本前瞻性研究采用前后对照设计，比较标准产后护理与标准产后护理加专注于盆底恢复的远程医疗泌尿妇科咨询。主要结局是产后16周时通过盆底困扰量表（PFDI-20）评分衡量的症状负担。使用QQ10和患者赋能工具评估患者体验。采用t检验和卡方检验比较组间差异。
共有119名参与者完成了研究活动（对照组n = 62，干预组n = 57）。两组的PFDI-20评分无显著差异（55.6对46.6，p = 0.23）。所有参与者中最常认可的单项与排气失禁（52.1%）和排便急迫感（49.6%）有关。对于35例严重OASI（3C级或四度撕裂）患者的亚组分析，接受远程医疗咨询的患者PFDI-20评分较低（56.6对34.7；p = 0.04）。QQ10评估远程医疗咨询的价值评分为79/100，负担评分为18/100。
专注于盆底健康的产后远程医疗咨询可能使报告症状负担减轻的严重OASI患者受益。参与者对这种情况下的远程医疗咨询评价为高价值和低负担。
