THE EFFECTS OF EPISIOTOMY AND KEGEL EXERCISES ON POSTPARTUM PELVIC RELAXATION - A PROSPECTIVE CONTROLLED-STUDY

To evaluate the effects of episiotomy and Kegel exercises on symptoms and signs indicating postpartum pelvic relaxation, we prospectively st udied 100 primigravidas consecutively enrolled from a homogeneous pati ent population. A control group was defined as the first 20 women requ iring cesarean section prior to labor for accepted indications. The re maining four groups of 20 women each were treated as follows: no episi otomy or Kegel, episiotomy but no Kegel, episiotomy plus postpartum Ke gel, and episiotomy plus antepartum Kegel. Research outcomes included the incidence and severity of pelvic relaxation determined by physicia ns blinded to group assignment and complaints of stress urinary incont inence. Fisher's exact tests were used for comparisons. Episiotomy alo ne was associated with decreased incidence of cystocele and rectocele, but there was no effect on degree of defects that occurred. Episiotom y plus antepartum Kegel produced no significant difference compared wi th cesarean controls for any defect of pelvic relaxation and, furtherm ore, was the only vaginal delivery group producing no third-degree def ects. This study supports the use of episiotomy in most primigravidas and further suggests that teaching of Kegel exercises be included in a ntepartum patient instruction.