https://doi.org/10.4081/ejtm.2025.13822
Study of the relationship between mediolateral episiotomy in vaginal delivery and pelvic organ prolapse in pregnant mothers
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Published: 21 May 2025
Pelvic Floor Disorders (PFDs) are a group of disorders of the female reproductive system that can cause a variety of problems for women. PFDs can include Urinary Incontinence (UI) and Pelvic Organ Prolapse (POP). This study evaluated the association between mediolateral episiotomy during pregnancy and POP in patients. A cross-sectional study with prospective follow-up was conducted on 150 pregnant women admitted for vaginal delivery at Furqani Hospital in Qom, Iran. Participants were divided into episiotomy and non-episiotomy groups based on clinical indications. Pelvic organ prolapse was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system at baseline and 3-6 months postpartum. Data were analyzed using SPSS version 26, with a significance level of 0.05. The study included 142 patients with a mean age of 29.67 years. No significant differences were observed in demographic or clinical variables between the episiotomy and non-episiotomy groups at baseline. Postpartum, the episiotomy group showed significant improvements in cystocele severity (P=0.038), rectocele severity (P=0.026), apical prolapse (P=0.011), levator tone (P=0.016), and perineal descent (P=0.016). However, the cough test results did not differ significantly (P=0.052). Mediolateral episiotomy during vaginal delivery was associated with reduced severity of POP and improved PFD. These findings suggest a potential protective effect of episiotomy against certain pelvic floor complications, although further studies with larger sample sizes and longer follow-up periods are needed to confirm these results.
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Good MM, Solomon ER. Pelvic floor disorders. Obst Gynecol Clinics 2019;46:527-40. DOI: https://doi.org/10.1016/j.ogc.2019.04.010
Gonzalez DC, Khorsandi S, Mathew M, Enemchukwu E, Syan R. A systematic review of racial/ethnic disparities in female pelvic floor disorders. Urology 2022;163:8-15. DOI: https://doi.org/10.1016/j.urology.2021.09.018
Kettle C, Dowswell T, Ismail KM. Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears. Cochrane Database Syst Rev 2012;11:CD000947. DOI: https://doi.org/10.1002/14651858.CD000947.pub3
Azimi S, Modarres SZ, Esgandari M, Fahimi SA, Fazeli R. Evaluation of the effect of embryo transfer methods on pregnancy outcomes: a retrospective study and future perspectives. J Reproduct Infertil 2024;25:140. DOI: https://doi.org/10.18502/jri.v25i2.16008
Massoudifar A, Alimi N, Boostan A, et al. Investigating the relationship between the perception of labor pain and the number of deliveries. J Obstet Gynecol Cancer Res 2023;8:549-55. DOI: https://doi.org/10.30699/jogcr.8.6.549
Klein MC, Kaczorowski J, Robbins JM, et al. Physicians' beliefs and behaviour during a randomized controlled trial of episiotomy: consequences for women in their care. Canadian Med Assoc J 1995;153:769.
Sartore A, De Seta F, Maso G, et al. The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery. Obstet Gynecol 2004;103:669-73. DOI: https://doi.org/10.1097/01.AOG.0000119223.04441.c9
Woolley RJ. Benefits and risks of episiotomy: a review of the English-language literature since 1980. Part I. Obstet Gynecol Surv 1995;50:806-20. DOI: https://doi.org/10.1097/00006254-199511000-00020
Aytan H, Tapisiz OL, Tuncay G, Avsar FA. Severe perineal lacerations in nulliparous women and episiotomy type. Eur J Obstet Gynecol Reproduct Biol 2005;121:46-50. DOI: https://doi.org/10.1016/j.ejogrb.2004.10.013
Thacker SB, Banta HD. Benefits and risks of episiotomy: an interpretative review of the English language literature, 1860–1980. Obstet Gynecol Survey 1983;38:322-38. DOI: https://doi.org/10.1097/00006254-198306000-00003
Klein MC, Gauthier RJ, Robbins JM, et al. Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. Am J Obstet Gynecol 1994;171:591-8. DOI: https://doi.org/10.1016/0002-9378(94)90070-1
Hartmann K, Viswanathan M, Palmieri R, et al. Outcomes of routine episiotomy: a systematic review. JAMA 2005;293:2141-8. DOI: https://doi.org/10.1001/jama.293.17.2141
Aytan H, Tok EC, Ertunc D, Yasa O. The effect of episiotomy on pelvic organ prolapse assessed by pelvic organ prolapse quantification system. Eur J Obstet Gynecol Reproduct Biol 2014;173:34-7. DOI: https://doi.org/10.1016/j.ejogrb.2013.11.010
Frigerio M, Mastrolia SA, Spelzini F, et al. Long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse: a systematic review. Arch Gynecol Obstet 2019;299:317-25. DOI: https://doi.org/10.1007/s00404-018-5009-9
Doğan B, Gün İ, Özdamar Ö, Yılmaz A, Muhçu M. Long-term impacts of vaginal birth with mediolateral episiotomy on sexual and pelvic dysfunction and perineal pain. Jo Maternal-Fetal Neonat Med 2017;30:457-60. DOI: https://doi.org/10.1080/14767058.2016.1174998
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