Perineorraphy Versus Pelvic Floor Exercise - a Randomized Trial

Perineorraphy Versus Pelvic Floor Exercise - a Randomized Trial

The perineal body is commonly injured during labor. It is possible to perform a secondary repair, a perineorraphy, which aims to reduce the symptomatology after an improperly healed perineal tear. The aim of the randomized trial is to evaluate the results of such an operation compared with conservative treatment.

A randomized controlled trial which aims to evaluate objective and subjective outcomes following perineorraphy compared with pelvic floor exercise after vaginal delivery. 70 women seeking help for improperly healed perineal tear following vaginal delivery, matching our inclusion- and exclusion criteria, will be randomised into two different treatment groups, 35 to operative treatment, perineorraphy, and 35 to conservative treatment, tutored pelvic floor exercise. Assessment pre-and 6 months postoperatively will include clinical evaluation and condition specific validated questionnaires. Surgical characteristics and adverse events during follow-up are also registered.

Inclusion Criteria:

• women with 2nd or 3rd degree laceration during vaginal delivery seeking for help because of troublesome symptoms from the pelvic floor
• height of perineum 2 cm or less.
• A least 6 months post partum
• stopped "exclusive breastfeeding"
• no indication for other gynecological surgical procedure

Exclusion Criteria:

• history of 4th degree laceration
• connective tissue disorder (Systemic lupus erythematosus, Sjögrens syndrome, Polymyalgia rheumatica, Marfans syndrome, Ehlers-Danlos syndrome)
• current use of systemic corticosteroids
• diabetes mellitus
• suspect occult sphincter tear on ultrasound
• history of previous urogynecological operation