Effect of different episiotomy techniques on perineal pain and sexual activity 3 months after delivery

Introduction and hypothesis The effect of different episiotomy techniques on pain perception 3 months after delivery is unknown. Study aims were to explore the association between different episiotomy techniques and perineal pain 3 months after delivery and to assess female sexual activity in relation to episiotomy technique. Methods This is a prospective observational study, designed to investigate short-and long-term complications of different episiotomy techniques. All 300 participants were recruited and clinically examined during their postpartum hospital stay in order to evaluate episiotomy performance. A 3-month follow-up questionnaire addressing pain, sexual activity, and puerperal wound infection was distributed to 208 women who had scored perineal pain in a personal interview the first day after delivery. Results A response rate of 87.7% was obtained. We found no difference in pain score distribution by Visual Analogue Scale (VAS) when comparing midline, mediolateral, and lateral episiotomy techniques (p=0.32) or between midline and lateral incision points (p=0.58). Dyspareunia was reported by 33 out of 179 women, but no difference between episiotomy techniques (p=0.90), or between episiotomy incision points (p=0.14), was found. Perineal wound infection was reported by 9.5 %, but there was no significant difference between episiotomy techniques (p=0.73). Conclusions No difference was found in perineal pain perception 3 months postpartum between different episiotomy techniques or when comparing midline and lateral incision points. Dyspareunia was not associated with any particular episiotomy technique or incision point.