Anal sphincter defects and anal incontinence symptoms after repair of obstetric anal sphincter lacerations in primiparous women

• Published in: International Urogynecology Journal Vol. 19; no. 11; pp. 1503 - 1508
• Main Authors: Vaccaro, Christine, Clemons, Jeffrey L.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.11.2008; Springer Nature B.V
• Subjects: Adult; Anal Canal - diagnostic imaging; Anal Canal - injuries; Anal Canal - surgery; Anus Diseases - diagnostic imaging; Anus Diseases - physiopathology; Anus Diseases - surgery; Births; Delivery, Obstetric - adverse effects; Electromyography; Endosonography; Fecal Incontinence - diagnostic imaging; Fecal Incontinence - etiology; Fecal Incontinence - physiopathology; Female; Follow-Up Studies; Gynecology; Humans; Medicine; Medicine & Public Health; Obstetrics; Original Article; Parity; Pregnancy; Prospective Studies; Rupture; Severity of Illness Index; Urology; Obstetric anal sphincter laceration; Anal incontinence; Endosonographic anal sphincter defect
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-008-0667-y

A study was carried out to identify (1) incidence of anal incontinence symptoms, (2) incidence and size of both external anal sphincter (EAS) and internal anal sphincter (IAS) defects, and (3) relationship between anal incontinence symptoms and IAS or EAS defect size after repair of an obstetric anal sphincter laceration. Forty-seven vaginally primiparous women underwent obstetric anal sphincter laceration repair. At 8–12 weeks postpartum, anal incontinence symptoms were assessed, and endoanal ultrasound was performed. At 1–2 years postpartum, symptoms were reassesseds. The incidence of anal incontinence symptoms at 8–12 weeks was 43%. The incidence of IAS and EAS defects were 32% and 77%, respectively. IAS defects ≥45 degrees were predictive of symptoms ( p  = 0.02). After 18 months mean follow-up, 11% reported chronic symptoms. After anal sphincter laceration repair, anal incontinence symptoms occur in 43% of women and remain chronic in 11%. Anal incontinence symptoms are associated with increasing IAS defect size.