The outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Martina Arcieri, Ginevra Battello, Annalisa Graziano, Matteo Alfarè Lovo, Stefano Restaino, Francesco D'Antonio, Alessandro Lucidi, Michela Segatti, Marina Comuzzi, Elisa Barbui, Chiara Carpenedo, Emanuele Biasutti, Lorenza Driul, Giuseppe Vizzielli
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引用次数: 0

Abstract

Purpose: The objective of this study is to evaluate the impact of pelvic floor physical therapy (PFPT) on symptoms and quality of life in women who experienced third- and fourth-degree perineal tears (Obstetric Anal Sphincter Injuries, OASIS) during childbirth. OASIS can lead to anal incontinence and dyspareunia, having important implications regarding the quality of life and health of women but, unfortunately, there is no standard practice for postpartum care following OASIS.

Methods: In this retrospective observational study, patients diagnosed with OASIS between January 2016 and June 2023 were enrolled. Since 2016, all women with OASIS have been routinely referred for physiatric evaluation and pelvic floor rehabilitation. Validated questionnaires (Wexner score and Marinoff scale) were administered to enrolled women to assess anal incontinence and dyspareunia.

Results: The study included 148 women, of whom 88 responded to the questionnaires. Participants were divided into two groups: those who underwent PFPT (N = 68) and those who declined it (N = 20). The mean follow-up period was 1447.35 days. The Wexner score was lower in the PFPT group compared to the no-PFPT group (p = 0.050). The Marinoff score did not show a statistically significant difference between the two groups (p = 0.381).

Conclusion: PFPT was shown to be effective in reducing AI symptoms in women with OASIS, improving quality of life and maintaining its effects in the long term, but without providing benefits for dyspareunia. Strengths of this study include the use of validated questionnaires, the long follow-up period, and the involvement of a specialized team of physiatrists and physiotherapists.

产科肛门括约肌损伤的早期会阴康复的结果:单中心经验。
目的:本研究的目的是评估盆底物理治疗(PFPT)对分娩期间经历三度和四度会阴撕裂(产科肛门括约肌损伤,OASIS)的妇女的症状和生活质量的影响。OASIS可导致肛门失禁和性交困难,对妇女的生活质量和健康有重要影响,但不幸的是,对于OASIS后的产后护理没有标准做法。方法:在这项回顾性观察研究中,纳入了2016年1月至2023年6月诊断为OASIS的患者。自2016年以来,所有患有OASIS的女性都被常规转诊进行生理评估和盆底康复。对入组妇女进行有效问卷调查(Wexner评分和Marinoff量表),以评估肛门失禁和性交困难。结果:研究纳入了148名女性,其中88人回答了问卷。参与者被分为两组:接受PFPT的(N = 68)和拒绝接受PFPT的(N = 20)。平均随访1447.35天。PFPT组的Wexner评分低于无PFPT组(p = 0.050)。Marinoff评分两组间差异无统计学意义(p = 0.381)。结论:PFPT可有效减轻OASIS女性的AI症状,改善生活质量并长期维持其效果,但对性交困难无益处。本研究的优势包括使用有效的问卷,长时间的随访,以及一个由物理医生和物理治疗师组成的专业团队的参与。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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