Is evacuation proctography still the gold standard for the diagnosis of posterior compartment pelvic floor disorders?

Abstract

levator ballooning between women with or without episiotomy (20 (19.4%) versus 23 (22.8%); p = 0.557) Oxytocine use was found to be a protective factor for LA (OR 0.48 (95% CI 0.234-0.990) p = 0.047). The duration of the second stage of labour increased the risk for LA (OR 1.01 (95% CI 1.001-1.028). Non occiput anterior fetal position increased the risk for ballooning and for pelvic floor injuries (OR 10.38 (95% CI 1.87-57.66) and OR 11.01 (95% CI 1.26-96.03). There were neither differences in urogynecological complaints between women with or without episiotomy nor between women with or without pelvic floor injuries.Interpretation of results: Pelvic floor injury is related with a prolonged second stage of labor, but not with episiotomy.Conclusions: Episiotomy has no influence in developing pelvic floor injuries or urogynecological complaints. References[1] Kapoor DS, Thakar R, Sultan AH. Obstetric anal sphincter injuries: review of anatomical factors and modifiable second stage interventions. Int Urogynecol J 2015 Dec;26(12):1725-34. [2] Verghese TS, Champaneria R, Lapoor DS, Latthe PM. Obstetric anal sphincter injuries after episiotomy: systematic review and meta-analysis. Int Urogynecol J The effect of a mediolaterale episiotomy during operative vaginal delivery on the risk of developing obstetrical anal sphincter injuries. Am J Obstet Gynecol 2012 May;206(5):404.