Mediolateral versus lateral episiotomy and their effect on postpartum coital activity and dyspareunia rate 3 and 6 months postpartum

•This prospective follow-up study compared coital activity and dyspareunia after mediolateral or lateral episiotomy.•Episiotomies were properly executed according to a new international classification.•Quality of sexual activity and pain perception was consistent between the two types of episiotomy.

ObjectivesComparison of the effects of two episiotomy types on sexual activity, dyspareunia and overall satisfaction after childbirth.Study designA prospective follow-up study of a randomized comparative trial evaluating peripartum outcome of a vaginal delivery after mediolateral (MLE) or lateral (LE) episiotomy.Main outcome measuresThe participants completed questionnaires regarding sexual activity, dyspareunia, perineal pain, aesthetic appearance and overall satisfaction 3 (3M) and 6 months (6M) postpartum.ResultsA total of 648 women were available for the analyses (306 MLE, 342 LE). The groups showed no difference regarding resumption and regularity of sex, timing of resumption, frequency and intensity of dyspareunia, perineal pain, aesthetic appearance or overall satisfaction 3M or 6M postpartum. 98.0% of women after MLE and 97.7% after LE resumed sexual intercourse within 6M after delivery (p = 0.74). In the same period 15.6% of women after MLE and 16.1% after LE suffered from considerable dyspareunia (p = 0.86).ConclusionsQuality of sexual life and perception of perineal pain after MLE is equivalent to LE.