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Standardized Episiotomy Using a Blade-Based Device Reduces Long-Term Perineal Pain and Improves Sexual Function: A
Sabahattin Anil Ari1, Seyda Ceylan Ari2, Semra Karaman3
1Department of Obstetrics and Gynecology, Faculty of Medicine, İzmir Bakırçay University, İzmir, Türkiye.
International Urogynecology Journal
|June 17, 2026
Summary
A standardized blade-based episiotomy technique significantly reduced persistent perineal pain and improved sexual function at six months postpartum compared to conventional scissors. This finding offers a better approach for mediolateral episiotomies when clinically indicated.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Surgery
- Women's Health
Background:
- Mediolateral episiotomy is sometimes necessary during vaginal delivery.
- Incision techniques may impact postpartum pelvic floor morbidity.
- Current methods lack standardization, potentially leading to varied outcomes.
Purpose of the Study:
- To compare a standardized blade-based episiotomy technique with conventional scissors.
- To evaluate the impact on persistent perineal pain at six months postpartum.
- To assess changes in postpartum sexual function.
Main Methods:
- Randomized controlled trial involving 60 nulliparous women requiring mediolateral episiotomy.
- Intervention group received episiotomy with a standardized blade-based device (BasIQ-4).
- Control group received episiotomy with conventional scissors; pain and sexual function were assessed at 2 hours, 48 hours, and 6 months postpartum.
Main Results:
- The blade-based group showed lower pain scores at 2 hours postpartum.
- Persistent perineal pain at six months was significantly lower in the blade-based group (6.7% vs. 50.0%).
- Female Sexual Function Index (FSFI) scores were significantly higher in the blade-based group, particularly in pain-related domains.
Conclusions:
- Standardized blade-based episiotomy significantly reduces long-term perineal pain.
- This technique improves pain-related aspects of sexual function after mediolateral episiotomy.
- Blade-based standardization is recommended for mediolateral episiotomies when indicated.