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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Related Experiment Video

Updated: Nov 18, 2025

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
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Midline and Mediolateral Episiotomy: Risk Assessment Based on Clinical Anatomy.

Danielle K Garner1, Akash B Patel1, Jun Hung1

  • 1Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA.

Diagnostics (Basel, Switzerland)
|February 5, 2021
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Summary
This summary is machine-generated.

Midline episiotomies risk external anal sphincter injury, while mediolateral incisions endanger more perineal structures. Understanding anatomy aids in diagnosing and preventing complications from this common surgical procedure.

Keywords:
bulbs of the vestibulemediolateral episiotomymidline episiotomyperineal nerve

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Area of Science:

  • Obstetrics and Gynecology
  • Anatomy
  • Surgical Complications

Background:

  • Episiotomy is a common surgical procedure during vaginal delivery.
  • Despite its frequency, episiotomy can lead to various short- and long-term complications.

Purpose of the Study:

  • To correlate common postepisiotomy complications with the risk of injury to perineal neuromuscular and erectile structures.
  • To compare the anatomical risks associated with midline versus mediolateral episiotomy incisions.

Main Methods:

  • Performed 61 midline and mediolateral episiotomies on 47 female cadavers.
  • Dissected the perineal area around incision sites to identify iatrogenic injuries.

Main Results:

  • Midline incisions did not sever major neuromuscular structures but increased risk to the external anal sphincter.
  • Mediolateral incisions presented a higher risk of injury to ipsilateral nerves, muscles, erectile tissues, and glands.

Conclusions:

  • Different episiotomy techniques pose distinct risks to maternal perineal anatomy.
  • Knowledge of perineal anatomy is crucial for clinicians to minimize complications and diagnose issues effectively.