Actualización en el manejo del dolor crónico posterior y dependiente del tipo de episiotomía practicada
Palabras clave:
Episiotomía, episiotomía medial, episiotomía mediolateral, dolor crónico, dolor perineal.Resumen
La episiotomía es una incisión quirúrgica vaginal y perineal controlada, que debe realizarse por indicaciones maternas o fetales, como evitar laceraciones maternas graves o facilitar o acelerar partos difíciles. Las complicaciones de las episiotomías incluyen extensión accidental al esfínter anal o recto, resultados anatómicos insatisfactorios como asimetría o estrechamiento excesivo del introito, hemorragia, dehiscencia de la herida, fistulas rectovaginales, dolor perineal, incontinencia urinaria o fecal, dispareunia. La técnica de reparación y el tipo de sutura utilizada también pueden afectar el resultado de la reparación de la episiotomía.
Dentro de las complicaciones a mediano y corto plazo, se ha descrito el dolor crónico pos episiotomía, como el dolor desarrollado después de la intervención o aumentado en intensidad después del procedimiento, que debe durar al menos 3 meses con un efecto negativo significativo en la calidad de vida. Se ha evidenciado que la episiotomía selectiva tiene menores tasas de dolor perineal crónico, dispareunia e incontinencia urinaria comparado con la episiotomía rutinaria.
Citas
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