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- Title
Association between sexual dysfunction and avulsion of the levator ani muscle after instrumental vaginal delivery.
- Authors
García‐Mejido, José A.; Idoia‐Valero, Irene; Aguilar‐Gálvez, Isabel M.; Borrero González, Carlota; Fernández‐Palacín, Ana; Sainz, José A.; García-Mejido, José A; Idoia-Valero, Irene; Aguilar-Gálvez, Isabel M; Fernández-Palacín, Ana
- Abstract
<bold>Introduction: </bold>The effects of levator ani muscle (LAM) avulsion after instrumental delivery on the sexual function of patients are currently unknown. Therefore, the objective of our study was to use a validated questionnaire, namely, the Female Sexual Function Index (FSFI), to compare the sexual function in patients with and without LAM avulsion after instrumental vaginal delivery.<bold>Material and Methods: </bold>This was a prospective observational study of 112 primiparous women after instrumental (vacuum or forceps) vaginal delivery. The obstetric and general characteristics of the population were studied. At 6 months postpartum, the contraceptive method used and the occurrence of LAM avulsion (using four-dimensional transperineal ultrasound) were determined, and the FSFI was administered.<bold>Results: </bold>A total of 100 patients (62 without avulsion and 38 with avulsion) completed the study. Thirty-eight (38%) were diagnosed with avulsion (42.1% after Kielland forceps delivery, 57.9% after Malmström vacuum delivery; P = .837). Women with LAM avulsion had significantly lower scores for desire (2.9 ± 1.2 vs 3.4 ± 1.1; P = .049), arousal (2.8 ± 1.7 vs 3.6 ± 1.4; P = .014), lubrication (2.3 ± 1.4 vs 3.0 ± 1.2; P = .011), orgasm (2.6 ± 1.6 vs 3.3 ± 1.2; P = .006) and satisfaction (3.1 ± 1.8 vs 3.9 ± 1.5; P = .051) than did women without LAM avulsion. The overall FSFI score was lower in patients with avulsion (16.7 ± 8.9 vs 20.7 ± 6.9, P = .033). These results were obtained after controlling for confounders (delivery mode, induced labor, birthweight, perineal tears, avulsion degree, contraceptive method and group assignment for the parent study) in the multivariate analysis (F = 4.974, P = .001).<bold>Conclusions: </bold>Patients with LAM avulsion present a higher degree of sexual dysfunction compared wiith patients without avulsion at 6 months after instrumental vaginal delivery.
- Subjects
SEXUAL dysfunction; MUSCLES; MULTIVARIATE analysis; CHILD care workers; BIRTH weight; RESEARCH; ULTRASONIC imaging; RESEARCH methodology; OBSTETRICAL extraction; OBSTETRICAL forceps; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; PELVIC floor; PUERPERIUM; RESEARCH funding; DELIVERY (Obstetrics); LABOR complications (Obstetrics); LONGITUDINAL method
- Publication
Acta Obstetricia et Gynecologica Scandinavica, 2020, Vol 99, Issue 9, p1246
- ISSN
0001-6349
- Publication type
journal article
- DOI
10.1111/aogs.13852