Impact of epysiotomy on anal continence in women after vaginal delivery

Abstract

Aim: The purpose of this study to determine the impact of episiotomy use in women after vaginal delivery on the female anal continence Methods: The study was designed as a cross-sectional. It was performed at the University Clinic of Obstetrics and Gynecology, University of "Ss. Cyril and Methodius" in Skopje, Macedonia during a period of one year. The study included 470 women of reproductive age with at least 1 previous vaginal delivery. The following variables were analyzed with regard to their influence on anal continence: use of episiotomy, type of episiotomy, perineal injury and degree of perineal injury. Data was acquired using a questionnaire specially designed for this study. The severity of anal incontinence quantified using St. Mark's Anal Incontinence Score. Results: Both the use of episiotomy and the severity of perineal trauma exerted a significant effect on anal continence. The use of episiotomy has been associated with lower St. Mark’s scores, while higher degrees of perineal trauma, were proven to significantly increase the value of the St. Mark’s score Conclusion: Anal incontinence is an unsettling condition affecting women that is inextricably linked to vaginal delivery. Further studies are needed to prove the benefit of episiotomy, which is traditionally regarded as a protective procedure and a method for prevention of pelvic floor disorders.