Anal function following third degree tears

• Published in: Colorectal disease Vol. 6; no. 2; pp. 92 - 96
• Main Authors: Mackenzie, N., Parry, L., Tasker, M., Gowland, M. R., Michie, H. R., Hobbiss, J. H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.03.2004
• Subjects: Anal Canal - diagnostic imaging; Anal Canal - injuries; Anal Canal - surgery; Anal function; Anus Diseases - etiology; Delivery, Obstetric - adverse effects; Digestive System Surgical Procedures - methods; Endosonography - methods; Female; Humans; Recovery of Function; third degree tears; Treatment Outcome
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2004.00568.x

Objective  To assess the anal function of women who have suffered a third degree perineal tear during parturition. Patients  Fifty‐three consecutive women who sustained a third degree tear, between January 1998 and March 2000, at the Princess Anne Maternity Unit, Royal Bolton Hospital were assessed. Methods  Women were assessed at 3 months post partum using the Cleveland Clinic Incontinence Score, digital assessment of anal sphincter and endo‐anal ultrasound scan. Results  At 3 months post partum 75% of the participants had no symptoms of anal incontinence, 18% had mild symptoms and 7% had more severe symptoms. Anal endosonography demonstrated normal anal sphincters in 66% of participants, an abnormality in the external sphincter in 29% and a defect in both sphincters in 2%. There was poor correlation between symptoms and scan defects. Conclusion  The incidence of anal incontinence following repair of a third degree tear was not high and it is unlikely that we are missing a hidden pool of symptomatic women. No major change in management policy is required. The routine assessment of anal function in women who had sustained a third degree tear was appreciated by the women and enabled us to identify the small portion of women with significant symptoms.