Long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse: a systematic review

Matteo Frigerio, Salvatore A. Mastrolia, Federico Spelzini, Stefano Manodoro, David Yohay, Adi Y. Weintraub

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

Purpose: To focus attention on the long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse. Methods: A systematic review was conducted including only studies with mean follow-up ≥ 5 years. We searched using combinations of the following keywords and text words: “episiotomy”, “perineal laceration”, “perineal tear”, “perineal damage” and “long term”, “long term outcomes”, “prolapse”, “pelvic organ prolapse”, “pelvic floor”, “pelvic floor dysfunction”, “urinary incontinence”, “hysterocele”, “cystocele” and “rectocele”. Results: The electronic database search provided a total of 6154 results. After exclusions, 24 studies were included yielding the following results: (1) episiotomy might be detrimental with respect to urinary incontinence symptoms; (2) the relationship between episiotomy and anti-incontinence surgery is not clear; (3) episiotomy does not seem to negatively influence genital prolapse development and might even be protective with respect to prolapse severity and prevalence; (4) episiotomy does not seem to affect genital prolapse surgery rate. Conclusions: We did not find evidence for a long-term beneficial effect of episiotomy in the prevention of urinary incontinence symptoms and anti-incontinence surgery. Episiotomy does not seem to negatively influence genital prolapse development and might even be protective with respect to prolapse severity and prevalence without affecting surgery rates.

Original languageEnglish
Pages (from-to)317-325
Number of pages9
JournalArchives of Gynecology and Obstetrics
Volume299
Issue number2
DOIs
StatePublished - 5 Feb 2019
Externally publishedYes

Keywords

  • Episiotomy
  • Long-term outcomes
  • Pelvic floor dysfunction
  • Pelvic organ prolapse
  • Systematic review
  • Urinary incontinence

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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