Does mediolateral episiotomy decrease central defects of the anterior vaginal wall?

Abstract

Objective: This retrospective study investigates the effects of mediolateral episiotomy on the pelvic floor.

Methods: Premenopausal women suffering from urinary incontinence/genital prolapse who delivered only by vaginal route were enrolled into the study. History of diabetes, morbid obesity (BMI > 40 kg/m(2)), vacuum/forceps extraction, perineal lacerations that warranted repair during labor and any pelvic surgery were the exclusion criteria. Evaluation of the patients included pelvic organ prolapse quantification scores, presence of stress incontinence, urethral hypermobility, and questionnaires were obtained for overactive bladder and anal incontinence symptoms. These data obtained from patients with the history of mediolateral episiotomy were compared with those of patients with no episiotomy or any other pelvic injury that warranted surgical repair.

Results: Groups were identical by means of demographic data, POP-Q findings, signs and symptoms of the pelvic floor. However, in the MLE group, central defects on the anterior vaginal wall were less frequent.

Conclusion: According to the results of this retrospective study, MLE seems to prevent central defects on the anterior vaginal wall. Prospective randomized studies are needed to draw a sufficient conclusion.