Fecal incontinence: a review of prevalence and obstetric risk factors

Abstract

Anal incontinence (AI) is a significant problem that causes social and hygienic inconvenience. The true prevalence of AI is difficult to estimate due to inconsistencies in research methods, but larger studies suggest a rate of 2-6% for incontinence to stool. There is a significant association between sonographically detected anal sphincter defects and symptoms of AI. The intrapartum factors most consistently associated with a higher risk of AI include: forceps delivery, third or fourth degree tears, and length of the second stage of labor. Fetal weight of > 4,000 g is also associated with AI. Repair of the sphincter can be performed in either an overlapping or an end-to-end fashion, with similar results for both methods. The role of cesarean delivery for the prevention of AI remains unclear, and further study should be devoted to this question.

Operative Vaginal Delivery: A Cause of Birth Injury or Is It?

“…Damage both directly to the anal sphincter in the form of third and forth degree lacerations and indirectly from nerve damage are proposed to be contributing factors for fecal incontinence. 48,64 As operative vaginal delivery is associated with an increased chance of sphincter injury, it follows that there will be an increase in anal incontinence. Most contemporary studies have evaluated anal incontinence within 5 years after delivery.…”

Reasons for non-disclosure of faecal incontinence: a comparison between two survey methods

“…The CCF-FI contains five questions on solid and liquid faecal soiling, flatus control, pad wearing and adjustments to daily living made necessary by FI. This frequently used instrument has been shown to provide both valid and reproducible results [9,25].…”

Økt forekomst av keisersnitt – årsaker og konsekvenser

“…Dette har vaert et argument for liberal bruk. I oversiktsartikler er det imidlertid konkludert med at selv om instrumentell vaginal forløsning er en risikofaktor for anal inkontinens, er det ikke vist at keisersnitt er entydig beskyttende (32). Tilsvarende er det rapportert at selv om keisersnitt har en kortvarig beskyttende effekt mot mild urininkontinens, er det ikke forskjell i alvorlig urininkontinens etter forløsningsmetode (33), heller ikke for kvinner over 50 år (34).…”