Magdalena Jansova

Clinical evaluation of peripartum outcomes of mediolateral versus lateral episiotomy

To evaluate the incidence and extent of vaginal and perineal trauma among primiparous women after mediolateral and lateral episiotomy.

Stereophotogrammetry of the perineum during vaginal delivery.

To analyze deformation of the perineum during normal vaginal delivery in order to identify clinical steps that might be beneficial when executing manual perineal protection.

Anal incontinence severity assessment tools used worldwide

To conduct an international survey of anal incontinence assessment tools and the need to evaluate frequency of occurrence of fecal urgency.

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

OBJECTIVES Comparison of the effects of two episiotomy types on sexual activity, dyspareunia and overall satisfaction after childbirth. STUDY DESIGN A 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 MEASURES The participants completed questionnaires regarding sexual activity, dyspareunia, perineal pain, aesthetic appearance and overall satisfaction 3 (3M) and 6 months (6M) postpartum. RESULTS A 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). CONCLUSIONS Quality of sexual life and perception of perineal pain after MLE is equivalent to LE.

Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy

To evaluate short‐term perineal pain among primiparous women after mediolateral episiotomy (MLE) and lateral episiotomy (LE).

Anal incontinence and fecal urgency following vaginal delivery with episiotomy among primiparous patients

To investigate anal incontinence following mediolateral or lateral episiotomy during a first vaginal delivery.

Biomechanical comparison of a transiliac internal fixator and two iliosacral screws in transforaminal sacral fractures: a finite element analysis.

PURPOSE Vertically unstable sacral transforaminal fractures can be stabilized with a transiliac internal fixator (TIFI) or two iliosacral screws (IS). This study was designed to compare stiffness between TIFI and IS. METHODS Using CT images finite element model of the pelvis was developed. Denis II type fracture was simulated and fixed either with TIFI or two IS. The sacral base was loaded vertically (250-500 N), displacement magnitudes on medial and lateral fracture surface and the maximum bone stress were calculated. The intact pelvis was used as a reference. Stiffness was determined by linear regression of load and displacement, computed stiffness ratio %. The von Mises stress was expressed as % ratio, evaluation of colour mapping was made. RESULTS The mean stiffness ratio medially in TIFI was 75.22%, in IS 46.54% (p = 0.00005), laterally in TIFI 57.88%, in IS 44.74% ( p = 0.03996). The von Mises stress ratio of TIFI was 139.27%, of IS 565.35% ( p < 0.00001). CONCLUSIONS Significantly higher stiffness and lower stress were found in TIFI model. TIFI provides a lower risk of over-compression of the fracture line in comparison with IS. TIFI thus exhibits superiority for fixation of trans- foraminal fractures, particularly with comminutive zone.