Perineal Injury and Its Association with Postpartum Sexual Dysfunction among First Delivery Women

2021 ◽  
Vol 2 (3) ◽  
pp. 34-39
Author(s):  
Z. Nusee ◽  
M. N. Ainy ◽  
P. Hafizah
Keyword(s):  
Sexual Dysfunction ◽  
Vaginal Delivery ◽  
Female Sexual Dysfunction ◽  
Family Income ◽  
Mode Of Delivery ◽  
Sexually Active ◽  
Perineal Tear ◽  
Health Clinics ◽  
Perineal Injury ◽  
Significant Difference

Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum, 107 (44.6%) sustained 1st degree perineal tear, 96 (40%) 2nd degree tear and three (1.25%) 3rd degree tear. Among the respondents, 60.9% of the sexually active respondents who had vaginal delivery, reported to have PPFSD. The timing of sexual resumption does not correlate with the severity of perineal tear. The severity of perineal tear is significantly associated with age (p=0.018), duration of marriage (p=0.008), body mass index (BMI) (p=0.019) and instrumental delivery (p=0.025). The level of personnel skill whom performed the repair were also found to have a significant relationship to PPFSD (p= 0.001). The relationship of participants’ mean age (p=0.271), marriage duration (p=0.903), race (p=0.928), religion (p=0.852), education level (p=0.549), employment status (p=0.102), family income (p=0.460) and BMI(p=0.159) with presence of PPFSD were all found to be statistically not significant. Conclusion: Occurrence of PPFSD is high among sexually active women who had vaginal delivery complicated by perineal tear, especially among those requiring instrumentation. The severity of perineal tear is associated with age, duration of marriage, BMI and mode of delivery. However, PPFSD does not significantly relate to the severity of perineal tear. None of the socio-demographic factors show a significant difference to sexual dysfunction.

scholarly journals Quality of Life and Female Sexual Dysfunction in Croatian Women with Stress-, Urgency- and Mixed Urinary Incontinence: Results of a Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 240
Author(s):  
Ivan Radoja ◽  
Dunja Degmečić
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Cross Sectional Study ◽  
Mixed Urinary Incontinence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Background and objectives: Urinary incontinence is defined as the involuntary leakage of urine. Studies have reported that the severity of urinary incontinence symptoms can cause decreased quality of life and female sexual dysfunction in women, but the association between the duration of the incontinence and the aforementioned disturbances has not been evaluated. The objective of this study was to evaluate the differences in the occurrence of decreased quality of life and female sexual dysfunction in Croatian women with urinary incontinence, with regard to the duration and subtype of urinary incontinence. Materials and Methods: We conducted a cross-sectional study from March 2017 to July 2018 at our neurourology and urodynamics outpatient clinic, among 120 women with urinary incontinence symptoms. Based on medical history, physical exam and urodynamic assessment, participants were divided into groups with stress-, urgency- and mixed urinary incontinence. Several quality of life and female sexual dysfunction questionnaires were used for evaluation. The differences between the three UI groups were tested by the Kruskal–Wallis test. All p values were two-sided. The level of significance was set to Alpha = 0.05. Results: The mixed urinary incontinence group had a significantly inferior quality of life (p = 0.003) and lower scores on the female sexual dysfunction questionnaires (p = 0.02). The longer the duration of incontinence King’s Health Questionnaire total score was worse (p = 0.003) and Female Sexual Function Index total score was worse (p < 0.001). Conclusions: Our results showed that there was a statistically significant difference in the occurrence of decreased quality of life and female sexual dysfunction considering the duration and subtype of incontinence in Croatian women.

scholarly journals Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term

2018 ◽  
Vol 7 (3) ◽  
pp. 824 ◽  
Author(s):  
Manoj Kumar Sah ◽  
Saraswati M. Padhye
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Human Reproduction ◽  
Cervical Ripening ◽  
Birth Canal ◽  
Significant Difference ◽  
Group A ◽  
Pass Through ◽  
Group B

Background: The cervix has to play dual role in human reproduction. During pregnancy, it should remain firm and closed allowing the fetus to grow in utero until functional maturity is attained while during labour it should soften and dilate, allowing the fetus to pass through the birth canal. Objective of present study was to know and compare the effect of oral Mifepristone with intracervical dinoprostone gel for cervical priming prior to induction of labour at term in an unfavorable cervix of primigravida.Methods: This was prospective randomized comparative study. 100 primigravid patients were included, 50 were placed in each group A and B. Tablet Mifepristone 200mg orally was given in group A patients and intracervical dinoprostone gel induction was done in group B patients. Pre induction Bishop’s score was noted at beginning to compare improvement in Bishop’s score after induction. Mode of delivery and induction to delivery interval in both the groups were studied.Results: After induction with Mifepristone 76% women had successful cervical ripening as compared to 56% with dinoprostone. Rate of vaginal delivery was 70% with Mifepristone and 58% with dinoprostone. There was no significant difference in induction to delivery interval between the groups. Ten percent and 2% belonging to mifepristone and dinoprostone group respectively, required NICU admissions.Conclusions: Mifepristone is more effective than dinoprostone for preinduction cervical ripening as it has high success rate of achieving cervical ripening, however there is no significant difference in the vaginal delivery rate and other maternal and fetal outcome.

Sexual function in adult cancer survivors.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 123-123 ◽  
Author(s):  
Emily Jo Rajotte ◽  
K. Scott Baker ◽  
Leslie Heron ◽  
Karen Leslie Syrjala
Keyword(s):  
Quality Of Life ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Cancer Survivors ◽  
Sexual Satisfaction ◽  
Sexually Active ◽  
Clinic Appointment ◽  
Significant Difference ◽  
Adult Cancer Survivors

123 Background: Sexual dysfunction is a common treatment sequela across numerous cancer diagnoses and treatments, causing increased distress, discomfort and negatively impacting quality of life. Methods: Before their survivorship-focused clinic appointment, adult cancer survivors were asked to complete a comprehensive patient -eported outcomes survey that included detailed questions on their health status including sexual function. Results: Between April 2015 to July 2016, 94 patients completed the survey. They were 66% female, mean age 45 years (SD 16, range 21-82) and 34% leukemia/lymphoma, 18% breast cancer, and 12% genitourinary cancer survivors. Patients were a mean of 6.7 years (SD 7.9, range 0-42) from their cancer diagnosis at the time of clinic appointment. Nearly half (48%) were married or living with a partner and 49% were living alone (single, divorced, widowed). 70.2% reported being sexually active (alone or with a partner) in the last year: of these only half (55.3%) reported being sexually active in the last month. For those who were not sexually active the most commonly cited reasons included lack of interest (24.5%) and not having a partner (30.9%), with 12.8% reporting not being sexually active due to a physical problem. Survivors rated their sexual satisfaction in the past month as a 5.0 (SD 3.7; scale of 0-10, 0=not at all satisfying 10=extremely satisfying). An independent samples t-test revealed a statistically significant difference in sexual satisfaction between survivors under 45 years in age and ≥45 years in age (t=4.4, df=68.0, p < 0.05). Older survivors (mean=3.71, SD=3.7) reported significantly lower levels of sexual satisfaction than did younger survivors (mean=7.11, SD=2.8). The most commonly reported sexual function issues for women included vaginal dryness (23.4%) and for men included difficulty getting an erection (7.4%). Conclusions: Sexual dysfunction is a common long-term effect of cancer across diagnoses and most treatments, warranting widespread implementation of targeted interventions to manage sexual dysfunction and improve quality of life for these survivors.

Cesarean delivery may increase the risk of multiple sclerosis

2011 ◽  
Vol 18 (4) ◽  
pp. 468-471 ◽  
Author(s):  
Amir-Hadi Maghzi ◽  
Masoud Etemadifar ◽  
Kiyan Heshmat-Ghahdarijani ◽  
Safieh Nonahal ◽  
Alireza Minagar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cesarean Section ◽  
Birth Order ◽  
Vaginal Delivery ◽  
Conditional Logistic Regression ◽  
Mode Of Delivery ◽  
Age At Onset ◽  
Significant Risk ◽  
Significant Difference ◽  
Healthy Siblings

Background: Prenatal and perinatal factors are believed to contribute to the risk of developing multiple sclerosis (MS). Objective: This study was designed to evaluate whether mode of delivery (vaginal versus cesarean section), as a perinatal factor, affects susceptibility to MS. Methods: MS patients were recruited from the MS registry of Isfahan Multiple Sclerosis Society (IMSS) and were compared with their healthy siblings. Data regarding mode of delivery, birth order, and gestation week of birth were obtained through a specially designed questionnaire. Preterm or post term deliveries were excluded. We used conditional logistic regression statistics and adjusted for gender and birth order. Results: This study included 1349 participants (449 MS patients and 900 controls). Subjects who were born by cesarean section had significant risk of MS (odds ratio, OR = 2.51; 95% confidence interval, CI: 1.43–4.41; p = 0.001). There was significant MS risk for females who were born by cesarean section (OR = 2.69, 95% CI: 1.30–5.58; p = 0.008), but not for males (OR = 2.25, 95% CI: 0.90–5.63; p = 0.082). The mean age at onset was lower in MS patients born by cesarean section (24.58 ± 6.33) compared with that of patients born by vaginal delivery (27.59 ± 7.97; p = 0.041). There was no significant difference between the two groups for birth order ( p = 0.417). Conclusion: Our results suggest that those born by vaginal delivery are at a lower risk of subsequent MS. These preliminary findings will need to be addressed in a much larger and preferably prospective study.

scholarly journals Female Sexual Dysfunction in Patients Treated with Antidepressants: A Comparison between Agomelatine and Escitalopram

2021 ◽  
pp. 196-204
Author(s):  
Virinder Kaur ◽  
Ng Chong Guan ◽  
Jesjeet Singh Gill ◽  
Low Sue-Yin
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Desire ◽  
Female Sexual Dysfunction ◽  
Rating Scale ◽  
Psychiatric Clinic ◽  
Depression Severity ◽  
Cross Sectional ◽  
Care Clinic ◽  
Significant Difference ◽  
Desire Disorder

Aim: This study aims to determine and compare the prevalence of Female Sexual Dysfunction (FSD) between patients on escitalopram and agomelatine, as well as to investigate possible factors associated with their usage. Study Design: Cross-sectional. Place and Duration of Study: Psychiatric Day Care Clinic, Department of Psychological Medicine, University Malaya Medical Centre (UMMC), Malaysia, between November 1, 2020 until February 1, 2021. Methodology: This study is a cross-sectional study involving 66 women with depression from the outpatient psychiatric clinic of a university hospital; 35 of whom were prescribed with escitalopram and 31 with agomelatine. The subjects were in remission and had no significant signs or symptoms of depression for at least 2 months. The prevalence of FSD between the two groups were compared after adjusting for underlying depression severity. Results: This study showed that the overall prevalence rate of FSD was 33.3%, with the prevalence being higher for those on escitalopram (42.9%) than those on agomelatine (22.6%), but did not achieve statistical significance (P=0.081). Out of the six domains of FSD, multivariate analyses revealed that there was a significant reduction of 69% in sexual desire disorder (95% CI:0.110, 0.855), P=0.022 for those on agomelatine compared to escitalopram. Controlling for drug dosage and depression severity (as measured using Montgomery-Asberg Depression Rating Scale), the odds for patients on agomelatine developing sexual desire disorder was 0.267 (95% CI:0.091, 0.783), P=0.016. Conclusion: There was no significant difference in FSD risk between patients on agomelatine and those on escitalopram. Patients on agomelatine were however less likely to develop sexual desire disorder, which demonstrates a slightly better sexual acceptability profile of agomelatine in women in this respect compared to escitalopram.

scholarly journals Predictors of Severe Perineal Tear during Delivery in Yenagoa, Southern Nigeria

2021 ◽  
pp. 42-51
Author(s):  
Ikobho Ebenezer Howells ◽  
Isaac Joel Abasi
Keyword(s):  
Multivariate Analysis ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Educational Level ◽  
Odds Ratio ◽  
Mode Of Delivery ◽  
Sphincter Injury ◽  
Perineal Tear ◽  
Anal Sphincter Injury

Background:Perineal tear is a very common complication of vaginal delivery, and it is often mild. However, when severe, it could result in torrential life threatening hemorrhage and anal sphincter injury, with fecal incontinence. Objective: The objective of this study is to determine the predictors of severe perineal tear (3rd and 4th degree tear), using mild perineal tear (1st and 2nd degree) as control. It would also determine the rate of perineal tear, and the maternal and fetal demographic risk factor associated with it. Materials and Methods: This was an analytic observational study of 186 women who had perineal tear during vaginal delivery. Out of these, 19 women had severe (3rd and 4th degree) perineal tear, also known as obstetrics anal sphincter injury (OASI). This was compared to 167 women who had mild perineal tear (1st and 2nd degree) during the study period. Maternal demographic information retrieved was maternal age, parity, educational level, and occupation. Obstetrics factors were booking status, gestational age at delivery, mode of delivery, rank of the accoucheur (nurse or doctor), and degree of perineal tear. Fetal demographic data was birth weight and fetal sex. Categorical variables were compared with odds ratio, difference in mean was compared with student’s t-test, and the degree of association for quantitative variables was determined using Pearson’s correlation coefficient. Predictor variables were determined using simple logistic regression, and multivariate analysis. Confidence interval was set at 95%, and statistical significance was set at p value of < 0.05. Results: The prevalence of OASI (3rd and 4th degree perineal tear) in Yenagoa was 1.1%. The significant risk factors were women of younger age, odds ratio = 1.04(0.37, 2.87) with p = 0.04, low parity, odds ratio = 0.20(0.07, 0.55) with p = 0.008, low educational background, odd ratio = 18.9(5.92, 60.81), and birth weight ≥ 4kg, odds ratio = 0.30[0.09, 1.06] with p = 0.04. Using simple liner regression, the most significant predictors for severe perineal tear were mode delivery (r2 = 65.5%), and educational level (r2 = 30.0%). However, on stepwise multivariate analysis, these two factors accounted for 68.5%. Conclusion: The rate of severe perineal tear is relatively low in Yenagoa, Nigeria, and comparable to what obtains in many countries. The most significant predictors were mode of delivery and educational level. Careful selection of the mode of delivery, especially instrumental vaginal deliveries, and women empowerment could minimize the rate in our environment.

scholarly journals Female sexual dysfunction in multiple system atrophy: a prospective cohort study

2021 ◽  
Author(s):  
Cecilia Raccagni ◽  
Elisabetta Indelicato ◽  
Victoria Sidoroff ◽  
Martin Daniaux ◽  
Angelika Bader ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Multiple System Atrophy ◽  
Sexual Function ◽  
Female Sexual Dysfunction ◽  
Autonomic Failure ◽  
Female Sexual Function Index ◽  
Motor Symptoms ◽  
Female Sexual Function ◽  
Sexually Active ◽  
Function Index

Abstract Purpose The diagnosis of probable multiple system atrophy relies on the presence of severe cardiovascular or urogenital autonomic failure. Erectile dysfunction is required to fulfil the latter criterion in men, whereas no corresponding item is established for women. In this study, we aimed to investigate sexual dysfunction in women with multiple system atrophy. Methods We administered the Female Sexual Function Index questionnaire and interviewed women with multiple system atrophy and age-matched controls regarding the presence of “genital hyposensitivity.” Results We recruited 25 women with multiple system atrophy and 42 controls. Female Sexual Function Index scores in sexually active women with multiple system atrophy were significantly lower (multiple system atrophy = 10; 15.4, 95% CI [10.1, 22.1], controls = 37; 26.1 [24.1, 28.1], p = 0.0004). The lowest scores concerned the domains of desire, arousal and lubrication. Genital hyposensitivity was reported by 56% of the patients with multiple system atrophy and 9% controls (p < 0.0001). Conclusions Sexual dysfunction is highly prevalent in women with multiple system atrophy. Screening for disturbances in specific sexual domains should be implemented in the clinical evaluation of women with suggestive motor symptoms.

Sexual function after 60

2002 ◽  
Vol 8 (3) ◽  
pp. 112-115 ◽  
Author(s):  
Kathryn May ◽  
Alan Riley
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Activity ◽  
Female Sexual Dysfunction ◽  
Healthcare Professionals ◽  
Sexually Active ◽  
Health It ◽  
Men And Women ◽  
Male Sexual Dysfunction ◽  
Seeking Help ◽  
Age And Sex

Ageing need not herald the end of a satisfying sex life. Research shows that men and women over the age of 60 can enjoy sexual activity, and it appears to be factors arising from the male that, most frequently, influence whether or not sexual activity will continue. With improved treatments now available to treat male sexual dysfunction and an ongoing search for greater understanding of the aetiology and management of female sexual dysfunction, in addition to improved general health, it is anticipated that the proportion of sexually active older people will increase. It is the responsibility of healthcare professionals to ensure that elderly people feel comfortable seeking help for sexual difficulties and that help is made available to all, irrespective of age and sex.

scholarly journals Comparison of clinical outcomes following CuT-380A insertion in postplacental period with interval insertion

2017 ◽  
Vol 6 (9) ◽  
pp. 4111
Author(s):  
Divya Chauhan ◽  
Shalini Gainder
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Abnormal Uterine Bleeding ◽  
Complication Rates ◽  
Expulsion Rate ◽  
Interval Group ◽  
Obstetrics And Gynaecology ◽  
Significant Difference ◽  
A Prospective Study

Background: Postplacental intra-uterine device has many benefits like providing contraception immediately after childbirth, non-interference with lactation and high efficacy. However, concerns about its safety have led to decreased use of this method of contraception. Hence, this study aims to compare the complication rates following insertion of immediate postplacental IUCD (PPIUCD) with interval insertion.Methods: This is a prospective study conducted under the Department of Obstetrics and Gynaecology in PGIMER, Chandigarh. 196 women were included in the study. Women were divided in two groups, those who were inserted with immediate postplacental IUCD versus those who had IUCD insertion in interval period. The two groups were followed up for a period of 6 months and complications were recorded. The PPIUCD group was further subdivided into 2 subgroups based on mode of delivery, vaginal delivery and caesarean section. These PPIUCD subgroups were also compared.Results: There was no statistically significant difference in the incidence of pelvic pain, infection, abnormal uterine bleeding and expulsion between the PPIUCD and interval group. However, when the PPIUCD subgroups were compared, it was seen that no woman in caesarean section subgroup had expulsion of IUCD whereas 9.8% women had expulsion in the vaginal delivery PPIUCD subgroup.Conclusions: Postplacental and interval IUCD seem to be comparable for the incidence of various complications. However, intra-caesarean PPIUCD insertion seems to have a much lower expulsion rate as compared to vaginal delivery PPIUCD insertion.

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