Impact of episiotomy on pelvic floor disorders and their influence on women's wellness after the sixth month postpartum: a retrospective study

A follow-up telephone interview was performed among 377 primiparous and secondiparous Caucasian women who had a child by spontaneous or operative vaginal delivery in 2006 using a self-created questionnaire and King's Health Questionnaire (KHQ).The mean age at delivery was 35.26 (±4.68) years and episiotomy was performed in 59.2% of women. Multivariate linear regression shows episiotomy associated to higher quality of life after the sixth month postpartum by correlating with inferior values of King's Health Questionnaire (p < 0.05).Episiotomy appears to be a protective factor for women's wellness. Women who had episiotomy and who experienced perineal symptoms have a better psycho-physical health status in the 12.79 months (±3.3) follow-up.Providing assistance in cases of spontaneous vaginal delivery presents a valuable opportunity to prevent perineal disorders such as urinary incontinence (UI), which, requiring surgical intervention in circa 400,000 women every year in the USA alone, has been compared to a hidden epidemic [1].UI prevalence rate in women is estimated at between 10% and 50% depending on age [2-5] - a study involving 1029 women with a mean age of 53 years in our region found a UI prevalence of around 44% [6]. UI in women is often assumed to be attributable to the effects of pregnancy and childbirth. In fact, among pregnant women, UI is a common occurrence compared with other groups of women, with reported prevalence rates ranging between 31% and 60% [7,8]. However, UI tends to be a self-limited condition postpartum, with persistent postpartum UI prevalence rates cited as variating between 0.7% and 44% [9-11].In addition to UI, many perineal disorders are commonly associated with vaginal delivery, such as anal incontinence, chronic pelvic pain, other lower urinary tract symptoms and dyspareunia, incidences of which are probably underestimated.Recent studies underline the importance of a better delivery management [12,13] in order to prevent perineal dama