Coital resumption after delivery among OASIS patients: differences between instrumental and spontaneous delivery

Anglès‐Acedo, Sònia; Ros‐Cerro, Cristina; Escura-Sancho, Sílvia; Elías-Santo-Domingo, Núria; Palau-Pascual, M José; Espuña‐Pons, Montserrat

doi:10.1186/s12905-019-0845-8

Cited by 7 publications

(14 citation statements)

References 25 publications

(48 reference statements)

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“…These findings have also been proved with a large prevalence at a long-term follow up [ 8 ]. Moreover, a history of OASIS delays the resumption of coital activity among women with spontaneous delivery, reflecting the long-term effects of severe perineal and pelvic trauma on postpartum sexuality [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

When does oasis cause de novo pelvic floor dysfunction? role of the surgeon's skills

et al. 2022

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Introduction and hypothesis Minorly skilled gynecologists are less likely to repair obstetric anal sphincter injuries (OASIS), and this can lead to higher rate of de novo onset of pelvic floor dysfunction (PFD). The aim of this study was to understand the impact of surgeon skills in OASIS repair on de novo incidence of PFDs. Methods An observational prospective cohort study performed between January 2019 and December 2020. We included 116 women with OASIS. At 6-weeks from delivery, women were divided into two groups in relation to the onset of PFDs. Characteristics were compared; categorical and continuous variables were assessed with chi-squared test and the Mann–Whitney rank-sum test respectively. Factors involved in PFDs development were analysed with explorative univariate analysis; significant (p<0.05) or approaching significance (p≤0.10) variables were included in multivariable analysis. Results Seventy-six women (76/116; 65.5%) reported at least one PFD symptom and anal incontinence was the most prevalent (44.73%; 34/76). OASIS management by a skilled gynaecologist resulted protective for PFDs [aOR 0.33 (0.13-0.61)]. Skilled surgeon reported fewer PFDs than less skilled surgeon (4% vs 82.4%; p<0.0001). Operative delivery was more performed (32.5% vs 15.8%; p= 0.03) and severe OASIS resulted more prevalent (60% vs 17.1%; p<0.0001) among women without PDFs, even if these didn’t affect the incidence of de novo PFDs [aOR 1.03 (0.23-1.45) and 0.83 (0.13-1.45), respectively]. Conclusions Surgeons skilled in OASIS repair resulted the only protective factor for incidence of de novo PFDs in women with OASIS at 6 weeks of follow up. Improvement of training in OASIS repair is necessary.

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Section: Discussionmentioning

confidence: 99%

When does oasis cause de novo pelvic floor dysfunction? role of the surgeon's skills

et al. 2022

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“…Finally, the PISQ-12 questionnaire may not be the best questionnaire to identify sexual dysfunction in our cohort of postpartum women. The PISQ-12 is validated to assess sexual function in women with urinary incontinence and/or pelvic organ prolapse, but has previously also been used to evaluate sexual function after vaginal delivery [26,27]. The EpiLeva study was conducted to assess the association of mediolateral episiotomy with levator injury and urogynecological complaints.…”

Section: Discussionmentioning

confidence: 99%

Postpartum sexual function; the importance of the levator ani muscle

2020

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Introduction and hypothesis Pelvic floor muscle function plays an important role in female sexual functioning. Smaller genital hiatal dimensions have been associated with sexual dysfunction, mainly dyspareunia. On the other hand, trauma of the levator ani muscle sustained during childbirth is associated with increased genital hiatus, which potentially can affect sexual functioning by causing vaginal laxity. This study aims to determine the association between levator hiatal dimensions and female sexual dysfunction after first vaginal delivery. Methods This is a secondary analysis of a prospective observational study. Two hundred four women who had a first, spontaneous vaginal delivery at term between 2012 and 2015 were recruited at a minimum of 6 months postpartum. Thirteen pregnant women were excluded. We analyzed the association of total PISQ-12 score, as well as individual sexual complaints (desire, arousal, orgasm and dyspareunia), with levator hiatal dimensions at rest, with maximum Valsalva and during pelvic floor muscle contraction as measured by 4D transperineal ultrasound. Statistical analysis was performed using linear regression analysis and Mann-Whitney U test. Results One hundred ninety-one women were evaluated at a median of 11 months postpartum. There was no significant association between total PISQ-12 score and levator hiatal dimensions. Looking at individual sexual complaints, women with dyspareunia had significantly smaller levator hiatal area and anterior-posterior diameter on maximum Valsalva. By using multivariate logistic regression analysis however we found dyspareunia was not independently associated with levator hiatal dimensions. Conclusions After first vaginal delivery sexual dysfunction is not associated with levator hiatal dimensions as measured by 4D transperineal ultrasound.

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“…Current breastfeeding had no impact on the total PISQ-12 score in our study, whereas Anglès-Acedo et al found a negative association at 6 months postpartum. However, their study was not restricted to primiparous women [3]. Question 4 regarding satisfaction with the variety of sexual activities was difficult to analyze because few women scored for dysfunction.…”

Section: Sexual Functionmentioning

confidence: 99%

“…In a study by Anglès-Acedo in 2019, women with operative vaginal delivery were less likely to be sexually active at 6 months postpartum than women with vaginal delivery without operative assistance [ 3 ]. The importance of vaginal tears and obstetric anal sphincter injuries (OASI) is unclear.…”

Section: Introductionmentioning

confidence: 99%

“…The importance of vaginal tears and obstetric anal sphincter injuries (OASI) is unclear. No difference in sexual satisfaction at 6 months postpartum was found among women with an intact perineum, second-degree perineal tear or OASI in one study [ 4 ], while another study described OASI as a risk factor for sexual inactivity at 6 months and for a lower sexual function score [ 3 ]. Furthermore, OASI has been found to be associated with less sexual activity after 1 year postpartum [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Sexual function in primiparous women: a prospective study

et al. 2022

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Introduction and hypothesis The aim of this prospective study was to examine the impact of sociodemographic, pregnancy and obstetric characteristics on sexual function 12 months postpartum in primiparous women. We hypothesized that sexual function would decrease after childbirth. Methods Between 1 October 2014 and 1 October 2017, all nulliparous women in early pregnancy registering for maternity health care in Region Örebro County, Sweden, were invited to participate in this prospective study. A total of 958 women were included. Sexual activity and function were measured at early pregnancy, 8 weeks postpartum and 12 months postpartum using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The associations between sociodemographic, pregnancy and obstetric characteristics and sexual activity and function from early pregnancy to 12 months postpartum were examined using linear and logistic models based on generalized estimating equations. Results We found that the prevalence of sexually active women decreased from 98.0% in early pregnancy to 66.7% at 8 weeks postpartum, but increased to 90.0% at 12 months postpartum. Age ≥ 35 years, second-degree perineal tear and current breastfeeding were statistically significant risk factors for sexual inactivity at 12 months postpartum. Poor self-reported health in early pregnancy was statistically significantly associated with decreased sexual function at 12 months postpartum. Conclusions A majority of women resumed sexual activity at 8 weeks postpartum and most women at 12 months postpartum; the decrease in sexual function at 12 months postpartum was small and few risk factors were observed.

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Coital resumption after delivery among OASIS patients: differences between instrumental and spontaneous delivery

Cited by 7 publications

References 25 publications

When does oasis cause de novo pelvic floor dysfunction? role of the surgeon's skills

When does oasis cause de novo pelvic floor dysfunction? role of the surgeon's skills

Postpartum sexual function; the importance of the levator ani muscle

Sexual function in primiparous women: a prospective study

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