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Observational Study
. 2025 Jun;311(6):1711-1719.
doi: 10.1007/s00404-024-07906-3. Epub 2025 Jan 27.

The outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience

Martina Arcieri  1 , Ginevra Battello  2 , Annalisa Graziano  2 , Matteo Alfarè Lovo  2 , Stefano Restaino  3   4 , Francesco D'Antonio  5 , Alessandro Lucidi  5 , Michela Segatti  1 , Marina Comuzzi  2 , Elisa Barbui  1 , Chiara Carpenedo  6 , Emanuele Biasutti  6 , Lorenza Driul #  1   2 , Giuseppe Vizzielli #  1   2
Affiliations
Observational Study

The outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience

Martina Arcieri et al. Arch Gynecol Obstet. 2025 Jun.

Abstract

Purpose: The objective of this study is to evaluate the impact of pelvic floor physical therapy (PFPT) on symptoms and quality of life in women who experienced third- and fourth-degree perineal tears (Obstetric Anal Sphincter Injuries, OASIS) during childbirth. OASIS can lead to anal incontinence and dyspareunia, having important implications regarding the quality of life and health of women but, unfortunately, there is no standard practice for postpartum care following OASIS.

Methods: In this retrospective observational study, patients diagnosed with OASIS between January 2016 and June 2023 were enrolled. Since 2016, all women with OASIS have been routinely referred for physiatric evaluation and pelvic floor rehabilitation. Validated questionnaires (Wexner score and Marinoff scale) were administered to enrolled women to assess anal incontinence and dyspareunia.

Results: The study included 148 women, of whom 88 responded to the questionnaires. Participants were divided into two groups: those who underwent PFPT (N = 68) and those who declined it (N = 20). The mean follow-up period was 1447.35 days. The Wexner score was lower in the PFPT group compared to the no-PFPT group (p = 0.050). The Marinoff score did not show a statistically significant difference between the two groups (p = 0.381).

Conclusion: PFPT was shown to be effective in reducing AI symptoms in women with OASIS, improving quality of life and maintaining its effects in the long term, but without providing benefits for dyspareunia. Strengths of this study include the use of validated questionnaires, the long follow-up period, and the involvement of a specialized team of physiatrists and physiotherapists.

Keywords: Incontinence; Obstetric anal sphincter injuries (OASIS); Pelvic floor rehabilitation; Postpartum care; Women’s health.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval and consent to participate: The study obtained approval from the ethics review committee (Institutional Review Board) on 15/09/2024 (reference number 180/2023) and was performed in accordance with the ethical standard as laid down in the Declaration of Helsinki. The data were anonymized and a written informed consent was obtained from all the patients. Consent for publication: All authors have provided consent for publication.

Figures

Fig. 1
Fig. 1
Study participants
Fig. 2
Fig. 2
Wexner score related to quality of life
See this image and copyright information in PMC

References

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