Actualización en el manejo del dolor crónico posterior y dependiente del tipo de episiotomía practicada

Abstract

Episiotomy is a controlled vaginal and perineal surgical incision, which should be performed for maternal or fetal indications, such as avoiding severe maternal lacerations or facilitating or accelerating difficult births. Complications of episiotomies include accidental extension to the anal or rectal sphincter, unsatisfactory anatomical results such as asymmetry or excessive narrowing of the introitus, hemorrhage, wound dehiscence, rectovaginal fistulas, perineal pain, urinary or fecal incontinence, dyspareunia. The repair technique and type of suture used can also affect the outcome
of episiotomy repair. Among the medium and short-term complications, chronic post-episiotomy pain has been described, such as pain developed after the intervention or increased in intensity after the procedure, which must last at least 3 months with a significant negative effect on quality. of life. It has been shown that selective episiotomy has lower rates of chronic perineal pain, dyspareunia and urinary incontinence compared to routine episiotomy.