Coital resumption after delivery among OASIS patients: differences between instrumental and spontaneous delivery

• Main Authors: Sònia Anglès-Acedo, Cristina Ros-Cerro, Sílvia Escura-Sancho, Núria Elías-Santo-Domingo, M. José Palau-Pascual, Montserrat Espuña-Pons
• Format: Article
• Language: English
• Published: BMC 2019-12-01
• Series: BMC Women's Health
• Subjects: Mode of delivery; OASIS; Perineal trauma; Coital resumption; Female sexual function; Vaginal delivery
• Online Access: https://doi.org/10.1186/s12905-019-0845-8

Abstract Background Obstetric anal sphincter injuries (OASIS) are associated with sexual dysfunction and a lower likelihood of sexual activity in the postpartum period. The aim of the present study was to compare coital resumption and the variables influencing this activity after delivery in women with and without a history of obstetric anal sphincter injury (OASIS) and according to the mode of delivery. Methods A prospective, observational, case-control study was performed at 6 months postpartum in 318 women: 140 with a history of primary repaired OASIS and 178 women without OASIS. Demographic and obstetric data, breastfeeding, and symptoms of urinary and anal incontinence were collected. Patients were asked about coital resumption and completed the validated specific Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12). Continuous and non-continuous variables were compared using ANOVA and the Fisher exact tests, respectively. A multivariate logistic regression model and a multiple regression analysis were constructed to assess the impact of demographic and clinical variables on the percentage of coital resumption and on the PISQ-12 score, respectively. Results After a spontaneous delivery (SD), patients without OASIS showed a higher percentage of coital resumption than those with OASIS (98% vs. 77%; p = 0.003), and the PISQ-12 score was also higher (p < 0.001). PISQ-12 score was better in women with SD compared to those with operative vaginal delivery (OVD)(p < 0.001), independently of the history of OASIS. Current breastfeeding, a higher Wexner score and OVD negatively influenced the PISQ-12 score. Conclusions After SD, women with OASIS resumed coital activity later than women without OASIS. Women with OVD resumed coital activity later, and had a lower PISQ-12 score than women with SD.