Comparison of the effects of episiotomy and no episiotomy on pain, urinary incontinence, and sexual function 3 months postpartum: A prospective follow-up study
Comparison of the effects of episiotomy and no episiotomy on pain, urinary incontinence, and sexual function 3 months postpartum: A prospective follow-up study
复制标题
DOI：
10.1016/j.ijnurstu.2010.07.017
复制
发表时间：
2011-04-01
影响因子：
8.1
通讯作者：
Lai, Yeur-Hur
中科院分区：
文献类型：
--
作者：
Chang, Shiow-Ru;Chen, Kuang-Ho;Lai, Yeur-Hur
背景：会阴切开率在全球范围内有所下降，但在台湾等几个国家仍居高不下。会阴切开术对女性健康的影响应该是一个持续关注的问题。本研究旨在探讨会阴切开术对产后3个月内疼痛、尿失禁及性功能的影响。设计、背景与对象：对243名在台湾某医疗中心完成简式麦吉尔疼痛问卷、国际会诊失禁问卷-尿失禁简表、女性性功能指数及产后人口学调查问卷的妇女进行前瞻性追踪研究。结果：未经会阴切开术分娩的产妇产后1、2、6周会阴痛评分显著低于会阴切开术产妇(p分别为0.0065、0.0391、0.0497)。在产后2周，非会阴切开组的非局限性疼痛评分显著低于会阴切开组(p=0.0438)。会阴切开组产后3个月尿失禁评分显著高于对照组(p=0.0293)。两组的性功能评分差异无统计学意义。结论：会阴切开术增加了产后1、2、6周的疼痛，增加了产后3个月的尿失禁。了解会阴切开术与妇女健康的关系将有助于卫生保健专业人员制定政策和推广限制性会阴切开术的应用。(C)2010爱思唯尔有限公司。保留所有权利。
Background: The episiotomy rate has declined worldwide but remains high in several countries such as Taiwan. The effects of episiotomy on women's health should be a constant concern. Few data are available on the effect of episiotomy by validated measures.Objective: The present study examined the effect of episiotomy on pain, urinary incontinence, and sexual function up to 3 months postpartum.Design, setting and participants: A prospective follow-up study of 243 women who completed the Taiwanese versions of the Short Form McGill Pain Questionnaire, International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form, Female Sexual Function Index, and a demographic questionnaire after vaginal delivery in a Taiwanese medical center.Methods: Differences between those who did and did not have an episiotomy were tested using ANCOVA, adjusting for age, parity, newborn weight, and vacuum delivery. The reliability and validity of the measuring instruments were assessed using Cronbach's coefficient and factor analysis.Results: Women who delivered without an episiotomy had significantly lower perineal pain scores at weeks 1, 2 and 6 postpartum compared to women who had an episiotomy (p = 0.0065, 0.0391, 0.0497, respectively). Women in the no-episiotomy group had significantly lower non-localized pain scores at week 2 postpartum compared to women in the episiotomy group (p = 0.0438). The mean urinary incontinence score was significantly higher in the episiotomy group 3 months postpartum (p = 0.0293). No significant difference in sexual function score was found between groups.Conclusions: The results indicate that episiotomy increased pain at weeks 1, 2 and 6 postpartum, and urinary incontinence at 3 months postpartum. Awareness of the relationship between episiotomy and women's health will help health care professionals develop policy and promote the application of restrictive episiotomy. (C) 2010 Elsevier Ltd. All rights reserved.