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Introduction and Hypothesis <p>Although routine episiotomy is discouraged, mediolateral episiotomy remains necessary in selected clinical situations. Variability in incision technique may influence pelvic floor–related morbidity. We hypothesized that a standardized blade-based episiotomy technique would be associated with lower rates of persistent perineal pain and improved sexual function compared with conventional scissors.</p> Methods <p>In this randomized controlled trial, 60 nulliparous women undergoing vaginal delivery with a clinical indication for mediolateral episiotomy were randomized to episiotomy performed using a standardized blade-based device (BasIQ-4) or conventional Braun–Stadler scissors. Perineal pain was assessed using a visual analog scale at 2 and 48&#xa0;h postpartum. The primary outcome was persistent perineal pain at 6&#xa0;months postpartum, evaluated using a structured clinical interview. Sexual function at 6&#xa0;months was assessed using the Female Sexual Function Index (FSFI).</p> Results <p>Sixty nulliparous women were randomized and included in the intention-to-treat analysis (BasIQ-4, <i>n</i> = 30; scissors, <i>n</i> = 30). Baseline demographic and obstetric characteristics were largely similar between groups. Pain scores at 2&#xa0;h postpartum were lower in the BasIQ-4 group, with no differences at 48&#xa0;h. Persistent perineal pain at 6&#xa0;months was significantly less frequent in the BasIQ-4 group (6.7% vs. 50.0%, <i>p</i> &lt; 0.001). Total FSFI scores were significantly higher in the BasIQ-4group, primarily driven by differences in pain-related domains.</p> Conclusions <p>When mediolateral episiotomy is clinically indicated, incision standardization using a blade-based technique is associated with reduced long-term perineal pain and improved pain-related aspects of postpartum sexual function.</p>

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Standardized Episiotomy Using a Blade-Based Device Reduces Long-Term Perineal Pain and Improves Sexual Function: A Randomized Controlled Trial

  • 期刊论文

  • 发表日期：

    2026年6月17日

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  • Sabahattin Anil Ari,
  • Seyda Ceylan Ari,
  • Semra Karaman,
  • Ali Akdemir

摘要

Introduction and Hypothesis

Although routine episiotomy is discouraged, mediolateral episiotomy remains necessary in selected clinical situations. Variability in incision technique may influence pelvic floor–related morbidity. We hypothesized that a standardized blade-based episiotomy technique would be associated with lower rates of persistent perineal pain and improved sexual function compared with conventional scissors.

Methods

In this randomized controlled trial, 60 nulliparous women undergoing vaginal delivery with a clinical indication for mediolateral episiotomy were randomized to episiotomy performed using a standardized blade-based device (BasIQ-4) or conventional Braun–Stadler scissors. Perineal pain was assessed using a visual analog scale at 2 and 48 h postpartum. The primary outcome was persistent perineal pain at 6 months postpartum, evaluated using a structured clinical interview. Sexual function at 6 months was assessed using the Female Sexual Function Index (FSFI).

Results

Sixty nulliparous women were randomized and included in the intention-to-treat analysis (BasIQ-4, n = 30; scissors, n = 30). Baseline demographic and obstetric characteristics were largely similar between groups. Pain scores at 2 h postpartum were lower in the BasIQ-4 group, with no differences at 48 h. Persistent perineal pain at 6 months was significantly less frequent in the BasIQ-4 group (6.7% vs. 50.0%, p < 0.001). Total FSFI scores were significantly higher in the BasIQ-4group, primarily driven by differences in pain-related domains.

Conclusions

When mediolateral episiotomy is clinically indicated, incision standardization using a blade-based technique is associated with reduced long-term perineal pain and improved pain-related aspects of postpartum sexual function.