Artículo
Association between sexual dysfunction and avulsion of the levator ani muscle after instrumental vaginal delivery
Autor/es | García Mejido, José Antonio
Idoia-Valero, Irene Aguilar-Gálvez, Isabel M. Borrero González, Carlota Fernández Palacín, Ana Sáinz Bueno, José Antonio |
Departamento | Universidad de Sevilla. Departamento de Cirugía Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública |
Fecha de publicación | 2021 |
Fecha de depósito | 2024-01-26 |
Publicado en |
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Resumen | Introduction: 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, ... Introduction: 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. Material and methods: 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. Results: 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). Conclusions: Patients with LAM avulsion present a higher degree of sexual dysfunction compared wiith patients without avulsion at 6 months after instrumental vaginal delivery. |
Cita | García Mejido, J.A., Idoia-Valero, I., Aguilar-Gálvez, I.M., Borrero González, C., Fernández Palacín, A. y Sáinz Bueno, J.A. (2021). Association between sexual dysfunction and avulsion of the levator ani muscle after instrumental vaginal delivery. Acta Obstetricia et Gynecologica Scandinavica, 99 (9), 1246-1252. https://doi.org/10.1111/aogs.13852. |
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