ArticleActa obstetricia et gynecologica Scandinavica2023
One-year follow-up after standardized perineal reconstruction in women with deficient perineum after vaginal delivery.
Article in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Hyaluronidase for reducing perineal trauma.The Cochrane database of systematic reviews · 2024Pooled it
- Severity of perineal tears and deviations in perineal body anatomy: A three-dimensional ultrasound study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Urogenital Hiatus Closure System: A Framework for Understanding how Muscle, Motor Control, and Fascial Connections Interact in Normal and Failed Closure.International urogynecology journal · 2026Review
- Perineal Body Anatomy in Primiparas Assessed by Three-Dimensional Endovaginal and Endoanal Ultrasound: A Reliability Study.International urogynecology journal · 2026Article
- Women's experiences of life and healthcare after levator ani avulsion: a qualitative interview study.BMC women's health · 2025Article
- Pelvic floor-related sexual functioning in the first 24 months postpartum: Findings of a large cross-sectional study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- One-year follow-up after standardized perineal reconstruction in women with deficient perineum after vaginal delivery.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Understanding and addressing female pelvic pain - a multifaceted challenge.Acta obstetricia et gynecologica Scandinavica · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
introductionPerineal tears are common after childbirth and, if not surgically repaired, they may result in a deficient perineum that can cause symptoms of pelvic floor dysfunction. Perineal reconstruction aims to restore the perineal body and increase the support of the pelvic floor. The objective of the present study was to estimate symptom reduction after perineal reconstruction in patients with deficient perineum after vaginal delivery and to compare outcomes between participants with or without concomitant levator ani muscle deficiency. MATERIAL AND
methodsParticipants presenting at the Karolinska Pelvic Floor Center with symptoms of deficient perineum at least 1 year after vaginal birth were invited to the study. Inclusion criteria were a visible perineal scar and confirmed anatomic defect. Levator ani defects were assessed using the Levator Ani Deficiency score. A perineal reconstruction was performed in a standardized way. Subjective symptoms were evaluated using the validated "Karolinska Symptoms After Perineal Tear Inventory" at baseline and 1-year follow-up. A score difference in the symptom of an acquired sensation of a wide vagina was the primary outcome. Results were stratified by the presence or absence of a levator ani deficiency.
resultsA perineal reconstruction was performed in 131 patients and 128 patients completed the Karolinska Symptoms After Perineal Tear Inventory at baseline and 119 at follow-up. Median age was 36.1 (interquartile range [IQR] 7.9), median body mass index 22.3 (IQR 5.1) and a median of two vaginal deliveries. Fifty-four women (41.2%) had a levator ani deficiency. The mean score reduction for the item "Do you feel that your vagina is too wide/loose?" was -1.56 (SD 0.96; P < 0.001) from a mean score of 2.75 (maximum 3) at baseline. The mean total score reduction was -9.1 points (SD 5.3; P < 0.001) from a mean score of 18.4 (maximum 33) points at baseline. There were no significant differences between groups when stratifying by levator ani deficiency.
conclusionsOur results show that perineal reconstructive surgery significantly decreases symptoms of deficient perineum after vaginal delivery. A concomitant levator ani defect does not affect the symptom reduction of an acquired sensation of a wide vagina or the total score reduction after surgery.
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