Avaliação dos resultados das condições perineais após o reparo de trauma perineal com cola cirúrgica ou fio de sutura até 8 meses de pós-parto

Abstract

Introduction: In literature, there are few studies about the use of surgical glue for perineal repair after delivery. Objectives: To compare the intensity of perineal pain, the occurrence of urinary incontinence (UI), the pelvic floor muscle strength (PFMS), the sexual function (SF) and the satisfaction of women after perineal repair with surgical glue or suture yarn in the first 8 months after delivery. Methodology: Longitudinal study linked to a randomized controlled trial (RCT). The population was consisted of women attending a RCT who had normal delivery, underwent repair of first and/or second-degree perineal lacerations or episiotomy with Glubran 2 ® surgical glue (Experimental Group-EG) or with Vicry l® suture yarn (Control Group-CG) in a maternity hospital located in Itapecerica da Serra, São Paulo, and returned for evaluation or accepted to be evaluated in their homes. The women were followed-up during the first 8 months after delivery in six stages, with the first 3 stages corresponding to the RCT database, stage 4 to a cross-sectional study and stages 5 and 6 data to the current study. Stage 1: soon after normal delivery; stage 2: between 12 and 24 hours; stage 3: between 36 and 48 hours; stage 4: between 10 and 20 days; stage 5: between 50 and 70 days; stage 6: between 6 and 8 months after delivery. This study was approved by the Research Ethics Committee of EEUSP, under registration number 2.44.813. Results: A total of 140 women were evaluated in the first three stages, 110 women between 10 and 20 days after delivery (stage 4), 122 women between 50 and 70 days (stage 5) and 54 women between 6 and 8 months after delivery (stage 6). When comparing the intensity of perineal pain over time in the two types of perineal repair, EG presented better results than CG (p=0.001). However, there was no significance when comparing UI in the first five stages (p=0.699) and the use of ICIQ-SF in the sixth stage (p=0.835). Regarding PFMS, there was a difference of 4.96 points between the means of EG (mean 32.39; SD 14.03) and CG (mean 27.43; SD 12.75), but with no significance (p=0.331). As for SF, it was noticed that the EG women presented higher mean scores in all domains, but there was no significance (p=0.504). EG also presented better means in relation to women's satisfaction with perineal repair, but also with no significance (p=0.068). Conclusion: The use of surgical glue showed significantly lower perineal pain intensity in the first 8 months after delivery and better means related to PFMS, SF and women's satisfaction with perineal repair. Surgical glue may be a viable option to decrease the negative outcomes of perineal repair after normal delivery, as well as to increase women's satisfaction.