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Clinical Trial
. 2010 Sep 9:10:51.
doi: 10.1186/1471-2393-10-51.

A modified surgical approach to women with obstetric anal sphincter tears by separate suturing of external and internal anal sphincter. A modified approach to obstetric anal sphincter injury

Pelle G Lindqvist  1 , Mats Jernetz
Affiliations
Clinical Trial

A modified surgical approach to women with obstetric anal sphincter tears by separate suturing of external and internal anal sphincter. A modified approach to obstetric anal sphincter injury

Pelle G Lindqvist et al. BMC Pregnancy Childbirth. .

Abstract

Background: Long-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence.

Methods: In a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sphincter muscles with monofilament absorbable sutures. The principal outcome assessed by answers given to six questions, was a difference in anal incontinence score, between the study group and two control groups (women with prior OASI [n = 180] and primiparous women delivered vaginally without a diagnose of OASI [n = 100]).

Results: An anal incontinence score of zero (i.e., no symptoms) was found in 74% of the study group, 47% of the OASI control group, and 66% of the vaginal control group (p = 0.02 and 0.5, as compared to the study group).

Conclusions: A modified suturing technique was followed by significant improved one-year symptoms of anal incontinence as compared to historical cases.

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Figures

Figure 1
Figure 1
After the first stitch, the internal sphincter muscle may be visualised and appears as a pinkish curtain.
See this image and copyright information in PMC

References

    1. Pirhonen JP, Grenman SE, Haadem K, Gudmundsson S, Lindqvist P, Siihola S, Erkkola RU, Marsal K. Frequency of anal sphincter rupture at delivery in Sweden and Finland -- result of difference in manual help to the baby's head. Acta Obstet Gynecol Scand. 1998;77:974–977. doi: 10.1080/j.1600-0412.1998.771005.x. - DOI - PubMed
    1. Gjessing H, Backe B, Sahlin Y. Third degree obstetric tears: outcome after primary repair. Acta Obstet Gynecol Scand. 1998;77:736–740. doi: 10.1080/j.1600-0412.1998.770707.x. - DOI - PubMed
    1. Haadem K, Ohrlander S, Lingman G. Long-term ailments due to anal sphincter rupture caused by delivery -- a hidden problem. Eur J Obstet Gynecol Reprod Biol. 1988;27:27–32. doi: 10.1016/S0028-2243(88)80007-8. - DOI - PubMed
    1. Sultan AH, Monga AK, Kumar D, Stanton SL. Primary repair of obstetric anal sphincter rupture using the overlap technique. Br J Obstet Gynaecol. 1999;106:318–323. - PubMed
    1. Fitzpatrick M, Behan M, O'Connell PR, O'Herlihy C. A randomized clinical trial comparing primary overlap with approximation repair of third-degree obstetric tears. Am J Obstet Gynecol. 2000;183:1220–1224. doi: 10.1067/mob.2000.108880. - DOI - PubMed

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