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

Abstract

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.

Postpartum sexual health: a principle‐based concept analysis

“…The more questionable times reported are 3 days (Chang et al 2010), 14 days (Connolly et al 2005), 2Á5-3Á5 years (Woolhouse et al 2012) and 6 years (Baud et al 2011) postpartum. The very early timeframes give women little or no time to physically and emotionally recover from the birth.…”

“…The tools, in the main, place emphasis on measuring physical/biological functioning outcomes. Furthermore, many studies lack justification for their choice of outcomes measures (Moel et al 2010, Rathfisch et al 2010, Marsh et al 2011, use diverse timeframes for assessing sexual health, for example, from 3 days (Chang et al 2010)-6 years (Baud et al 2011) and focus on heterosexual penetrative vaginal sex (Barrett et al 2000, Bertozzi et al 2010, Hipp et al 2012. Collectively, these elements negatively impact on the useful application of the concept in practice.…”

“…Inconsistencies in linguistic use are evident as the term postpartum sexual health was often used interchangeably with postpartum sexuality (Hyde et al 1996, von Sydow 1999, Barrett et al 2000, DeJudicibus & McCabe 2002, Rowland et al 2005, Trutnovsky et al 2006, Pastore et al 2007, Shirvani et al 2010, Hipp et al 2012, Woolhouse et al 2012) and postpartum sexual function (Baksu et al 2007, Pauls et al 2008, Klein et al 2009, Safarinejad et al 2009, Citak et al 2010, Baud et al 2011, Chivers et al 2011, Hosseini et al 2012. This is further exacerbated by a lack of definitions of these terms and the multiplicity of issues addressed in each term in the literature.…”

“…These are components of postpartum sexual health rather than theoretically integrated concepts. Sexual satisfaction is frequently measured in the data as an indicator of sexual health (Dean et al 2008, Acele & Karacam 2011, Baud et al 2011, Hosseini et al 2012. Intimacy has been discussed in terms of the intimate relationship and how it can impact on sexual health, for example, discordance in sexual desire between partners (Pastore et al 2007).…”

Landmark-Based Shape Encoding and Sparse-Dictionary Learning in the Continuous Domain

“…This experiment is part of a clinical study where the structural and potential functional changes of the pelvic-floor hiatus (PFH) are examined after a woman has given birth to one or several children [43]. 3D ultrasound volumes of 245 women were acquired and grouped into 61 nulliparae (women who did not give birth to children) and 184 multiparae (women who gave birth to one or several children).…”