Clinical symptoms after anal sphincter rupture: a retrospective study

Wagenius, Johanna; Laurin, Jan

doi:10.1034/j.1600-0412.2003.00088.x

Cited by 50 publications

(21 citation statements)

References 24 publications

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“…The results of this study suggested that women with anal sphincter disruption had a slightly increased risk of fecal incontinence with no impact on urinary or sexual symptoms and mental or physical health [11]. In contrast, other authors reported a higher incidence of urinary symptoms [12,13] and sexual dysfunction [5,7,14,15] after anal sphincter tear.…”

Section: Introductioncontrasting

confidence: 46%

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Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery

et al. 2011

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Introduction and hypothesis This study aims to estimate fecal, urinary incontinence, and sexual function 6 years after an obstetrical anal sphincter tear. Methods Among 13,213 women who had a vaginal delivery of a cephalic singleton at term, 196 women sustained an anal sphincter tear. They were matched to 588 controls. Validated questionnaires grading fecal and urinary incontinence, and sexual dysfunction were completed by the participants. Results Severe fecal incontinence was more frequently reported by women who had sustained an anal sphincter tear compared to the controls. Women with an anal sphincter tear had no increased risk of urinary incontinence, but reported significantly more pain, difficulty with vaginal lubrication, and difficulty achieving orgasm compared to the controls. A fetal occiput posterior position during childbirth was an independent risk factor for both severe urinary incontinence and severe sexual dysfunction. Conclusions Fecal incontinence is strongly associated with an anal sphincter tear. A fetal occiput posterior position represents a risk factor for urinary incontinence and sexual dysfunction.

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Section: Introductioncontrasting

confidence: 46%

“…To estimate a sample size, we used five studies that evaluated fecal incontinence after an anal sphincter tear [5,6,9,13,14]. Based on these studies, the overall fecal incontinence rate was 40% (21-57%) and 20% (7-32%) for women with and without an anal sphincter tear, respectively.…”

Section: Methodsmentioning

confidence: 99%

Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery

et al. 2011

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“…35,36 We believe that our comparatively low incidence of postpartum faecal incontinence may have several explanations: Vigilance in detecting anal sphincter injuries may be comparatively high at our institution and it is departmental policy that all primary repairs are performed under regional anaesthesia in the operating theatre. Other reports may include patients whose repair was conducted under less optimal conditions, which may affect the outcome.…”

Section: Discussionmentioning

confidence: 99%

Immediate or delayed repair of obstetric anal sphincter tears—a randomised controlled trial*

Nordenstam

Mellgren

Altman

et al. 2008

BJOG

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Objective To investigate if an 8-to 12-hour time delay of primary repair affects anal incontinence at 1-year follow up.Design Randomised controlled trial.Setting University hospital in Sweden.Population A total of 165 women diagnosed with a third-to fourth-degree perineal tear.Methods The participants were randomised to immediate or delayed (8-to 12-hour delay) end-to-end repair; 78 were allocated to immediate operation and 87 to a delayed repair. An incontinence and pelvic floor symptom questionnaire was completed by the participants at baseline and at 6-and 12-month follow up.Main outcome measures Anal incontinence measured by the validated Pescatori incontinence score.Results A total of 161 (98%) and 155 (94%) women completed the two follow-up questionnaires. There was no significant difference in anal incontinence between the groups. There were no significant differences in pelvic floor symptoms between the groups. A multivariate proportional odds model revealed that increasing maternal age was significantly associated with both increased symptoms of faecal urgency and inability to discriminate flatus from faeces.Conclusion Delayed repair provided the same functional outcome at 1-year follow up. Delaying the repair should thus not be recommended routinely, but can be an alternative under special circumstances when appropriate surgical expertise is not readily available.Keywords Anal incontinence, obstetric anal sphincter tear, primary repair, randomised controlled trial.

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“…[12] Studies show that OASR might have severe physical and physiological effects on women. [13][14][15][16] They reported feeling upset, tired, angry, resigned, frustrated and a sense of loss. They felt abandoned and vulnerable during labor and birth, suturing and the postpartum period as a result of the actions of their health care providers.…”

Section: Introductionmentioning

confidence: 99%

“…[16] Despite the negative effects of OASR on women's daily lives few seek medical assistance. [15] Aim of the study The aim of this study was to describe women's experiences of living with ongoing severe difficulties of an OASR ≥ 8 weeks after delivery.…”

Section: Introductionmentioning

confidence: 99%

Feeling old in a young body: Women’s experiences of living with severe consequences of an obstetric anal sphincter rupture: An interview study

Elden

Olesen²,

Svahn³

et al. 2014

Clinical Nursing Studies

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Background: The incidence of obstetric anal sphincter rupture (OASR) is increasing. It may cause anal incontinence and dyspareunia, leading to reduced quality of life and wellbeing. Qualitative studies are lacking. The aim was to describe experiences of living with ongoing severe consequences of an OASR ≥ 8 weeks after childbirth.Method: Twenty women with ongoing severe consequences of an OASR ≥ 8 weeks after delivery were interviewed using qualitative content analysis.Results: The experience of complications of an OASR is described in the overall theme "Feeling old in a young body" and four categories: The body as injured; isolation; inability to function sexually, and anxiety for the future. Participants described how the consequences of OASR totally occupied their lives, making them feel old in a young body. They told of repercussions for their physical, psychological, sexual and social lives; how it affected their roles of mothers and partners, making them fear future childbirths. Diet, use of medicines, coal filters in incontinence pads, timing of toilet visits, use of the environment and mobile phones to conceal flatus and/or feces were strategies participants described.Conclusions: This study can contribute to increased understanding of how women can be affected by an OASR, and may enable healthcare personnel and authorities to meet their needs and organize care so that adequate support is available. It would also be beneficial if the women's physical strategies were integrated into the information provided by health caregivers involved in follow-up. However, more research in this area is warranted.

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Clinical symptoms after anal sphincter rupture: a retrospective study

Abstract: Anal sphincter rupture is strongly associated with anal incontinence and dyspareunia several years postpartum. The complaints affect the daily lives of these women to a great extent.

Cited by 50 publications

References 24 publications

Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery

Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery

Immediate or delayed repair of obstetric anal sphincter tears—a randomised controlled trial*

Feeling old in a young body: Women’s experiences of living with severe consequences of an obstetric anal sphincter rupture: An interview study

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