Practical issues in the management of third and fourth degree tears to minimise the incidence of faecal incontinence

Faecal incontinence is underestimated in most epidemiological studies, probably because women may feel unable to discuss the symptoms they experience and avoid seeking medical advice. The most common cause of faecal incontinence in healthy women is an injury during a vaginal delivery. In this articl...

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Bibliographic Details
Published inCirugia Española Vol. 85; no. 6; p. 341
Main Authors Folch, Marina, Parés, David, Castillo, Maite, Carreras, Ramon
Format Journal Article
LanguageSpanish
Published Spain 01.06.2009
Subjects
Anal Canal - injuries
Anal Canal - surgery
Fecal Incontinence - epidemiology
Fecal Incontinence - prevention & control
Female
Humans
Incidence
Injury Severity Score
Obstetric Labor Complications - surgery
Pregnancy
Suture Techniques
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Summary:Faecal incontinence is underestimated in most epidemiological studies, probably because women may feel unable to discuss the symptoms they experience and avoid seeking medical advice. The most common cause of faecal incontinence in healthy women is an injury during a vaginal delivery. In this article we review the classification and terminology, as well as the risk factors, for third and fourth degree perineal tears. We also comment on the different suture techniques, the follow-up of women who sustain third and fourth degree tears and the advice given to those women regarding future pregnancies and mode of delivery. We highlight the importance of the endoanal ultrasound on the diagnosis of occult anal sphincter injury.
ISSN:0009-739X
DOI:10.1016/j.ciresp.2008.12.001