International Urogynecology Journal

, Volume 22, Issue 12, pp 1521–1528 | Cite as

Does the Epi-No® Birth Trainer reduce levator trauma? A randomised controlled trial

  • Ka Lai ShekEmail author
  • Varisara Chantarasorn
  • Susanne Langer
  • Hala Phipps
  • Hans Peter Dietz
Original Article


Introduction and hypothesis

The purpose of this study is to evaluate whether antepartum use of a birth trainer may reduce levator trauma.


Two hundred nulliparous women were examined with four-dimensional translabial ultrasonography at 35–37 weeks of gestation and 3 months postpartum in a randomised controlled pilot study. Women in the intervention group were instructed to use the birth trainer from 37 weeks onwards.


One hundred forty-six women returned for follow-up 5.6 months (range 2.3–22.1) after childbirth. Seventy-eight of them had had normal vaginal deliveries (53%), 32 vacuum/forceps (22%) and 36 a caesarean section (25%). The risk of avulsion was halved in the intervention group (6% vs 13%, P = 0.19) on modified intention to treat analysis. A treatment received analysis revealed a nonsignificant 42% and 30% reduction in levator avulsion and microtrauma, respectively (P ≥ 0.22).


This pilot randomised controlled trial showed a nonsignificantly lower incidence of pelvic floor muscle injury in women who used the Epi-No® device from 37 weeks onwards.


Childbirth Epi-No birth trainer Levator avulsion Levator microtrauma Pelvic organ prolapse Ultrasound 



The Epi-No® Birth Trainer was donated by the Starnberg Medical, Tecsana GMBH, Muenchen, Germany.

Conflict of interest statement

KL Shek, V Chantarasorn, S Langer and H Phipps have no conflict of interest to declare. HP Dietz has acted as a consultant for AMS (American Medical Systems) and CCS (Continence Control Systems); has accepted Speaker’s fees from GE (General Electric), AMS and Astellas and has benefited from equipment loans provided by GE, Bruel and Kjaer and Toshiba.


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Copyright information

© The International Urogynecological Association 2011

Authors and Affiliations

  • Ka Lai Shek
    • 1
    Email author
  • Varisara Chantarasorn
    • 1
  • Susanne Langer
    • 1
  • Hala Phipps
    • 2
  • Hans Peter Dietz
    • 1
  1. 1.Nepean Clinical School, Nepean HospitalUniversity of SydneySydneyAustralia
  2. 2.The Royal Prince Alfred Hospital Women and BabiesSydneyAustralia

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