Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct;127(1):47-50.
doi: 10.1016/j.ijgo.2014.04.013. Epub 2014 Jun 12.

Outcome of repair of obstetric anal sphincter injuries after three years

Annette J Reid  1 , Andrew D Beggs  2 , Abdul H Sultan  3 , Anne-Marie Roos  1 , Ranee Thakar  1
Affiliations

Outcome of repair of obstetric anal sphincter injuries after three years

Annette J Reid et al. Int J Gynaecol Obstet. 2014 Oct.

Abstract

Objective: To prospectively assess change in bowel symptoms and quality of life (QoL) approximately 3 years after primary repair of obstetric anal sphincter injuries (OASIS).

Methods: Between July 2002 and December 2007 women who attended the perineal clinic at Croydon University Hospital, UK, 9 weeks following primary repair of OASIS were asked to complete the Manchester Health Questionnaire and a questionnaire to obtain a St Mark incontinence score. All women had endoanal scans at this visit. In June 2008 all women were asked to complete the questionnaires again.

Results: Of 344 patients who responded to the questionnaires and were included in the analysis, long-term symptoms of fecal urgency, flatus incontinence, and fecal incontinence occurred in 62 (18.0%), 52 (15.1%), and 36 (10.5%), respectively. Overall, there was a significant improvement in fecal urgency (P<0.001) and flatus incontinence (P<0.001) from 9 weeks to 3 years. Of 31 women with fecal incontinence symptoms at early follow-up, 28 were asymptomatic at 3 years. However, 33 women developed de novo symptoms. The only predictors of fecal incontinence at 3 years were fecal urgency at 9 weeks (OR 4.65; 95% CI, 1.38-15.70) and a higher St Mark score (OR 1.40; 95% CI, 1.09-1.80).

Conclusion: Following primary repair of OASIS, the majority of symptoms and QoL significantly improve, unless there is a persistent anal sphincter defect. This highlights the importance of adequate repair.

Keywords: Bowel symptoms; Childbirth; Endoanal scan; Fecal incontinence; Obstetric anal sphincter injuries; Third-degree tears; Vaginal delivery.

PubMed Disclaimer

References

    1. Sultan A.H., Thakar R. In: Perineal and Anal Sphincter Trauma: Diagnosis and Clinical Management. Sultan A.H., Thakar R., Fenner D.E., editors. Springer; London: 2007. Third and Fourth Degree Tears; pp. 33–51.
    1. Fornell E.U., Matthiesen L., Sjödahl R., Berg G. Obstetric anal sphincter injury ten years after: subjective and objective long term effects. BJOG. 2005;112(3):312–316. - PubMed
    1. De Leeuw J.W., Vierhout M.E., Struijk P.C., Hop W.C., Wallenburg H.C. Anal sphincter damage after vaginal delivery: functional outcome and risk factors for fecal incontinence. Acta Obstet Gynecol Scand. 2001;80(9):830–834. - PubMed
    1. Nordenstam J., Altman D., Brismar S., Zetterström J. Natural progression of anal incontinence after childbirth. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1029–1035. - PubMed
    1. Sultan A.H. Editorial: Obstetric perineal injury and anal incontinence. Clin Risk. 1999;5(5):193–196.

Publication types