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Int Urogynecol J. 2016 Oct;27(10):1513-23. doi: 10.1007/s00192-016-3015-7. Epub 2016 May 16.

Sexual activity and dyspareunia the first year postpartum in relation to degree of perineal trauma.

Author information

1
Faculty of Medicine, University of Oslo, Oslo, Norway. kathrif@gmail.com.
2
Department of Obstetrics and Gynaecology, Oslo University Hospital, Ullevål, Postboks 4965, Nydalen, 0424, Oslo, Norway. kathrif@gmail.com.
3
Faculty of Medicine, University of Oslo, Oslo, Norway.
4
Department of Obstetrics and Gynaecology, Oslo University Hospital, Ullevål, Postboks 4965, Nydalen, 0424, Oslo, Norway.

Abstract

INTRODUCTION AND HYPOTHESIS:

Knowledge on sexual complaints and time to sexual resumption after obstetric anal sphincter injury (OASI) is scarce. The aim of the study was to investigate self-reported sexual activity and coital problems 1 year postpartum in relation to perineal trauma, in addition to delivery mode.

METHODS:

Among 2,846 women recruited during pregnancy, all women who delivered with OASI (n = 42, all third-degree perineal tears), in addition to 20 randomly selected controls per OASI case, a total of 882 women, were sent a self-administered questionnaire addressing time to coital resumption after delivery and potential coital difficulty 1 year postpartum.

RESULTS:

By 8 weeks, half of the 561 responders (51.4 %) had resumed intercourse, increasing to 75.2 % by 12 weeks and 94.7 % 1 year postpartum. In multivariate regression analysis OASI was the strongest predictor for postponed coital onset, defined as after 8 weeks (aOR 5.52, CI 1.59-19.16). OASI was also the only significant predictor for dyspareunia 1 year after delivery (aOR 3.57, CI 1.39-9.19). Episiotomy was neither a risk factor for postponed coital onset nor for dyspareunia. There were no differences between episiotomy and second-degree laceration injury groups regarding postponed coital onset (p = 0.45) or dyspareunia (p = 0.67) 1 year postpartum.

CONCLUSIONS:

Obstetric anal sphincter injury was a strong and independent predictor for both postponed coital resumption after delivery and for dyspareunia 1 year postpartum, whereas episiotomy and spontaneous second-degree lacerations were not. Our main finding of affected sexual activity after OASI further supports the need to reduce the rates of this obstetric injury to a minimum.

KEYWORDS:

Dyspareunia; Episiotomy; Obstetric anal sphincter injury; Sexual activity

PMID:
27185318
DOI:
10.1007/s00192-016-3015-7
[Indexed for MEDLINE]

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