Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study

Jingran Du, MD; Juntong Ye, MD; Hui Fei, MD; Mengxiong Li, MD; Juan He, BD; Lixiang Liu, MD; Yun Liu, MD; Tian Li, PhD

Sexual Medicine (Oct 2021)

Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study

Jingran Du, MD,
Juntong Ye, MD,
Hui Fei, MD,
Mengxiong Li, MD,
Juan He, BD,
Lixiang Liu, MD,
Yun Liu, MD,
Tian Li, PhD

Affiliations

Jingran Du, MD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Juntong Ye, MD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Hui Fei, MD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Mengxiong Li, MD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Juan He, BD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Lixiang Liu, MD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Yun Liu, MD: Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Tian Li, PhD: Corresponding Author: Tian Li, PhD, Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital Sun Yat-sen University, No. 628, Zhenyuan Road, Guangming Street, Guangming District, Shenzhen 518107, China. Tel: +86-0755-81206733; Department of Obstetrics and Gynecology, Pelvic Floor Disorder Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China

Journal volume & issue: Vol. 9, no. 5
p. 100417

Abstract

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Introduction: Epidural analgesia has become a universal intervention for relieving labor pain, and its effect on the pelvic floor is controversial. Aim: To investigate the effect of epidural analgesia on pelvic floor dysfunction (PFD) in primiparous women at 6 months postpartum. Methods: We performed a prospective cohort study involving 150 primiparous women in preparation for vaginal delivery, with 74 (49.3%) receiving epidural analgesia. Baseline demographic and intrapartum data were collected. At 6 months postpartum, PFD symptoms, including stress urinary incontinence, overactive bladder, defecation disorder, pelvic organ prolapse, and 4 kinds of sexual dysfunction (arousal disorder, low sexual desire, dyspareunia, and orgasm disorder), were evaluated. Pelvic floor muscle (PFM) function and postpartum depression were also assessed. Multivariate logistic regression was applied to identify factors associated with the PFD symptoms affected by epidural analgesia. Main outcome measure: PFD symptoms and sexual dysfunction were evaluated through Pelvic Floor Distress Inventory-20 (PFDI-20) and Female Sexual Function Index (FSFI-12). PFM function was examined with palpation and surface electromyography (sEMG). Postpartum depression was assessed using Self-Rating Depression Scale (SDS). Results: At 6 months postpartum, women who delivered with epidural analgesia had a higher incidence of dyspareunia (43.2% vs 26.3%, P 0.05). Multivariate logistic regression revealed that epidural analgesia (OR = 3.056, 95% CI = 1.217-7.671) and SDS scores (OR = 1.066, 95% CI = 1.009-1.127) were independent risk factors for dyspareunia. Conclusion: At 6 months postpartum in primiparous women, epidural analgesia was associated with an increased risk of postpartum dyspareunia and longer labor durations, which deserves attention for rehabilitation after delivery. Future studies with a larger sample size are needed to evaluate the impact of epidural analgesia on other PFD symptoms. Du J, Ye J, Fei H, et al. Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study. Sex Med 2021;9:100417.

Published in Sexual Medicine

ISSN: 2050-1161 (Online)
Publisher: Oxford University Press
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://academic.oup.com/smoa

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