Randomized prospective trial reveals increased anal sphincter injury but reduced scarring with midline episiotomy in primiparous women, indicating distinct trade-offs between incision techniques.
A randomised prospective study of 407 primiparous patients compared the consequences of midline and mediolateral episiotomies. The patients' estimates of the pain from their episiotomies were similar. Anal sphincter injury was significantly more common after a midline procedure but no rectovaginal fistulae occurred. Scarring was less noticeable after the midline incision and intercourse began earlier.
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Coats et al. (1980) studied this question.
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