Evidence map›Paper›PMID 25511413›Full record

ArticleBMC women's health2014

Anal incontinence, urinary incontinence and sexual problems in primiparous women - a comparison between women with episiotomy only and women with episiotomy and obstetric anal sphincter injury.

Mona Stedenfeldt, Jouko Pirhonen, Ellen Blix, Tom Wilsgaard, Barthold Vonen, Pål Øian

Registry-linked trialOpen access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC women's health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05317364 (Topical Vaginal Estrogen for Postpartum Obstetric Anal Sphincter Injury Recovery), which is not on this map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05317364 phase4terminatednot on this mapstarted 2022, after this paper: background citation

Topical Vaginal Estrogen for Postpartum Obstetric Anal Sphincter Injury Recovery: a Randomized Clinical Trial

TypeinterventionalSponsorUniversity of Alabama at BirminghamRan2022 to 2026Enrolled38ConditionsObstetric, Injury Pelvic Floor, Sexual Dysfunction, Anal IncontinenceArmsEstradiol 0.01% Vag Cream, Placebo vaginal cream
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Review
  6. Article
  7. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Mona StedenfeldtThe National Advisory Unit on Continence and Pelvic Floor Health, University Hospital of North Norway, Tromsø, Norway. mona.stedenfeldt@unn.no.
Jouko PirhonenThe National Advisory Unit on Continence and Pelvic Floor Health, University Hospital of North Norway, Tromsø, Norway. tj.pirhonen@gmail.com.
Ellen BlixResearch Group Maternal, Reproductive and Children's Health, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway. ellen.blix@hioa.no.
Tom WilsgaardDepartment of Community Medicine, Faculty of Health Science, University of Tromsø, Tromsø, Norway. tom.wilsgaard@uit.no.
Barthold VonenDepartment of Clinical Medicine, Women's Health and Perinatology Research Group, Faculty of Health Science, University of Tromsø, Tromsø, Norway. barthold.vonen@nordlandssykehuset.no.
Pål ØianDepartment of Clinical Medicine, Women's Health and Perinatology Research Group, Faculty of Health Science, University of Tromsø, Tromsø, Norway. pal.oian@unn.no.
UiT The Arctic University of Norway · NOUniversity Hospital of North Norway · NOOsloMet – Oslo Metropolitan University · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObstetric anal sphincter injuries (OASIS) might cause anal incontinence (AI) and sexual dysfunction, and might be associated with urinary incontinence (UI). Episiotomy has been identified both as a risk and a protective factor of OASIS. Lately, episiotomies with specific characteristics have shown to be protective against the risk of OASIS. However, little is known about episiotomy characteristics and pelvic floor dysfunction. This study investigates AI, UI, and sexual problems in primiparous women with episiotomy, comparing women with and without OASIS. Associations between episiotomy characteristics and AI, UI, and sexual problems were assessed.

methodsThis is a matched case-control study investigating 74 women with one vaginal birth, all with an episiotomy. Among these, 37 women sustained OASIS and were compared to 37 women without OASIS. The two groups were matched for vacuum/forceps. AI, UI and sexual problem symptoms were obtained from St. Mark's scoring-tool and self-administered questionnaires. The episiotomy characteristics were investigated and results assessed for the whole group.

resultsThe mean time from birth was 34.5 months (range1.3-78.2) for those with OASIS and 25.9 months (range 7.0-57.4) for those without OASIS, respectively. More women with OASIS reported AI: 14 (38%) vs. 3 (8%) p = 0.05 (OR 4.66, 95% CI 1.34-16.33) as well as more problem with sexual desire p = 0.02 (OR 7.62, 95% CI 1.30-44.64) compared to women without OASIS. We found no association between episiotomy with protective characteristics and dysfunctions.

conclusionWomen with OASIS had more AI and sexual problems than those without OASIS. Episiotomy characteristics varied greatly between the women. Episiotomy with protective characteristics was not associated with increased dysfunctions. OASIS should be avoided, and correct episiotomy used if indicated.

Indexed as

ParityAdolescentAdultAnal CanalCase-Control StudiesEpisiotomyFecal IncontinenceFemaleHumansLacerationsLibidoPregnancySeverity of Illness IndexTrauma Severity IndicesUrinary IncontinenceVacuum Extraction, Obstetrical

Identifiers

PMID25511413
PMCPMC4273460
OpenAlexW2118260235

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.