Fecal incontinence, sexual complaints, and anorectal function after third-degree obstetric anal sphincter injury (OASI): 5-year follow-up

2013 ◽  
Vol 25 (5) ◽  
pp. 607-613 ◽  
Author(s):  
A. P. Visscher ◽  
T. J. Lam ◽  
N. Hart ◽  
R. J. F. Felt-Bersma
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
Anorectal Function ◽  
Obstetric Anal Sphincter Injury ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

scholarly journals Does a missed obstetric anal sphincter injury at time of delivery affect short-term functional outcome?

2018 ◽  
Vol 100 (1) ◽  
pp. 26-32 ◽  
Author(s):  
L Ramage ◽  
C Yen ◽  
S Qiu ◽  
C Simillis ◽  
C Kontovounisios ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Sphincter ◽  
Short Form ◽  
Primary Repair ◽  
Obstetric Anal Sphincter Injury ◽  
Short Term ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment. Outcomes compared included Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score, Short Form-36, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and anorectal physiology results. Results Thirty-two missed anal sphincter injuries were matched two to one with sixty-two patients who underwent primary repair of an anal sphincter defect. Mean time to follow-up was 9.31 ± 6.79 months. Patients with a missed anal sphincter injury had suffered more incontinence, as seen in higher the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ; 30.56% ± 14.41% vs. 19.75% ± 15.65%, P = 0.002) and Wexner scores (6.00 ± 3.76 vs. 3.67 ± 4.06, P = 0.009). They also had a worse BBUSQ urinary domain score (28.25% ± 14.9% vs. 17.01 ± 13.87%, P = 0.001) and worse physical functioning as measured by the Short Form-36 questionnaire (P = 0.045). There were no differences in other outcomes compared, including anorectal physiology and sexual function. Discussion In the short-term, patients with a missed obstetric anal sphincter injury had significantly worse faecal incontinence and urinary function scores, however quality of life and sexual function were largely comparable between groups. Conclusions Longer-term follow-up is needed to assess the effects of missed obstetric anal sphincter injury over time.

Medium- to Long-term Follow-up of Obstetric Anal Sphincter Injury

2019 ◽  
Vol 62 (3) ◽  
pp. 348-356 ◽  
Author(s):  
Friyan D. Turel ◽  
Susan Langer ◽  
Ka Lai Shek ◽  
Hans Peter Dietz
Keyword(s):  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injury ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Long Term Follow Up

Obstetric anal sphincter injury: a follow-up questionnaire study on longer-term outcomes

2016 ◽  
Vol 27 (10) ◽  
pp. 1591-1596 ◽  
Author(s):  
Simone Cornelisse ◽  
Linda Petra Arendsen ◽  
Sander Martijn Job van Kuijk ◽  
Kirsten Birgit Kluivers ◽  
Jeroen van Dillen ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injury ◽  
Questionnaire Study ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

scholarly journals Which elements were significant in reducing obstetric anal sphincter injury? A prospective follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ole Bredahl Rasmussen ◽  
Annika Yding ◽  
Charlotte Sander Andersen ◽  
Jane Boris ◽  
Finn Friis Lauszus
Keyword(s):  
Anal Sphincter ◽  
Nulliparous Woman ◽  
Obstetric Anal Sphincter Injury ◽  
Care Bundle ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Follow Up Study ◽  
Anal Sphincter Injury ◽  
Perineal Support

Abstract Background To examine which elements of an obstetric anal sphincter injury (OASI) care bundle were protective for OASI. Several interventional trials showed that application of a care bundle involving a hands-on approach to perineal protection may reduce the risk of OASI. Previously, we found that only the element “hand on the fetal head” in itself was protective, although the risk of a type 2 error was calculated to be 50%. Methods A prospective follow-up study in an obstetric department in Denmark with 3200 deliveries per year. We included a cohort of 10,383 women giving birth vaginally from gestational week 22 + 0 from 2016 through 2019. We documented on a person-level the five elements of the care bundle together with maternal and obstetrical characteristics. The elements were 1) communication, 2) visible perineum, 3) hand on fetal head, 4) perineal support and 5) certification. Regression analysis was used for analysis of associations. The primary outcome measure was OASI. Results The total rate of OASI in vaginally delivering women was 1.9%. The incidence was 3.2% in nulliparous women giving birth vaginally. The rate of cesarean section was 16.5% and for episiotomy 2.4%. The reduction in the incidence of OASI was sustained since 2013. Hand on the fetal head and perineal support both were protective factors for OASI. In case of a nulliparous woman with a neonate weighing 3500 g giving birth spontaneously, the relative risk (RR) for OASI was 0.50 (95% CI 0.49- 0.51) with use of hand on the fetal head together with perineal support against no use. Similarly, with a nulliparous woman giving birth to a neonate of 3500 g by vacuum extraction, the RR for OASI was 0.65 (95% CI 0.62-0.68) against no use. Conclusions Both hand on the fetal head and perineal support were associated with a reduced risk of OASI.

scholarly journals A rare off-site aperture of the anal canal following an obstetric anal sphincter trauma.

2021 ◽  
Author(s):  
Sofoklis Stavros ◽  
Ioannis Papapanagiotou ◽  
Dimitris Zacharakis ◽  
Kyriaki Migklis ◽  
Rafail Mantzioros ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Anal Canal ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injury ◽  
Common Complication ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Perineal Injuries ◽  
Anal Sphincter Trauma

Obstetric anal sphincter injury is a common complication of vaginal delivery. Such injuries are more likely to result in postpartum fecal incontinence and thus diagnosis and restoration of perineal injuries at the time of vaginal delivery is of paramount importance.

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