Perineorraphy Versus Pelvic Floor Exercise - a Randomized Trial

NCT ID: NCT02545218

Last Updated: 2018-08-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2019-06-30

Brief Summary

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The perineal body is commonly injured during labor. It is possible to perform a secondary repair, a perineorraphy, which aims to reduce the symptomatology after an improperly healed perineal tear. The aim of the randomized trial is to evaluate the results of such an operation compared with conservative treatment.

Detailed Description

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A randomized controlled trial which aims to evaluate objective and subjective outcomes following perineorraphy compared with pelvic floor exercise after vaginal delivery. 70 women seeking help for improperly healed perineal tear following vaginal delivery, matching our inclusion- and exclusion criteria, will be randomised into two different treatment groups, 35 to operative treatment, perineorraphy, and 35 to conservative treatment, tutored pelvic floor exercise. Assessment pre-and 6 months postoperatively will include clinical evaluation and condition specific validated questionnaires. Surgical characteristics and adverse events during follow-up are also registered.

Conditions

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Perineal Tear Resulting From Childbirth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Perineorraphy.

Secondary surgical repair of the perineal body. Operation is performed by a urogynecologist in an operation theater in local anesthesia. The operation aims to re-create the anatomy in the injured perineum using 2-4 sutures.

Group Type ACTIVE_COMPARATOR

Perineorraphy

Intervention Type PROCEDURE

Surgery for improperly healed perineal tear

Pelvic floor exercise.

Tutored pelvic floor exercise. A trained physio therapist evaluate the pelvic floor musculature and helps the patient to perform proper pelvic floor exercises using biofeedback. The patient receives a training scheme and meets the therapist regularly every second week during 4 months.

Group Type ACTIVE_COMPARATOR

Pelvic floor exercise

Intervention Type OTHER

Pelvic floor exercise tutored by physio therapist.

Interventions

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Perineorraphy

Surgery for improperly healed perineal tear

Intervention Type PROCEDURE

Pelvic floor exercise

Pelvic floor exercise tutored by physio therapist.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* women with 2nd or 3rd degree laceration during vaginal delivery seeking for help because of troublesome symptoms from the pelvic floor
* height of perineum 2 cm or less.
* A least 6 months post partum
* stopped "exclusive breastfeeding"
* no indication for other gynecological surgical procedure

Exclusion Criteria

* history of 4th degree laceration
* connective tissue disorder (Systemic lupus erythematosus, Sjögrens syndrome, Polymyalgia rheumatica, Marfans syndrome, Ehlers-Danlos syndrome)
* current use of systemic corticosteroids
* diabetes mellitus
* suspect occult sphincter tear on ultrasound
* history of previous urogynecological operation
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Stockholm South General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Marion Ek

M.D. Ph.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marion Ek, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Stockholm South General Hospital

Locations

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Södersjukhuset

Stockholm, , Sweden

Site Status

Countries

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Sweden

References

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Woodman PJ, Graney DO. Anatomy and physiology of the female perineal body with relevance to obstetrical injury and repair. Clin Anat. 2002 Aug;15(5):321-34. doi: 10.1002/ca.10034.

Reference Type BACKGROUND
PMID: 12203375 (View on PubMed)

Harvey MA. Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction. J Obstet Gynaecol Can. 2003 Jun;25(6):487-98. doi: 10.1016/s1701-2163(16)30310-3.

Reference Type RESULT
PMID: 12806450 (View on PubMed)

Bergman I, Westergren Soderberg M, Ek M. Perineorrhaphy Compared With Pelvic Floor Muscle Therapy in Women With Late Consequences of a Poorly Healed Second-Degree Perineal Tear: A Randomized Controlled Trial. Obstet Gynecol. 2020 Feb;135(2):341-351. doi: 10.1097/AOG.0000000000003653.

Reference Type DERIVED
PMID: 31923073 (View on PubMed)

Other Identifiers

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StockholmSGH

Identifier Type: -

Identifier Source: org_study_id

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