Pubovisceral muscle and anal sphincter defects in women with fecal or urinary incontinence after vaginal delivery

Murad-Regadas, Sthela M.; Regadas, Francisco Sérgio Pinheiro; Filho, Francisco L. de Caldas; Borges, L B; Vilarinho, Adjra da Silva; Veras, Lara Burlamaqui; Regadas, Carolina Murad; Regadas, Marina Murad

doi:10.1007/s10151-018-1895-x

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…Other studies (9)(10)(11)(12)(13) did not find evidence that vaginal delivery is responsible for pelvic floor dysfunction. Panelists at a State-of-the-Science Conference sponsored by the National Institutes of Health determined for maternal outcomes related to pelvic floor function, weak-quality evidence did not favor either route of delivery.…”

Section: Discussionmentioning

confidence: 92%

“…Although several studies have found that pelvic floor dysfunction was correlated with mode of delivery in childbirth, parity, and age (6)(7)(8) , numerous contrary and inconsistent results have also been reported (3,(9)(10)(11)(12)(13) . Difference among study results may be due to heterogeneous populations studied, survey methods applied, definitions, and reference time, as well as the multifactorial nature of pelvic floor dysfunction (3)(4)(5) .…”

Section: Introductionmentioning

confidence: 98%

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Correlation Between Pelvic Floor Dysfunction on Dynamic 3d Ultrasound and Vaginal Delivery, Parity, and Age in Women With Obstructed Defecation Symptoms

Murad-Regadas

Vilarinho

Borges

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Few studies have investigated the constipation or obstructed defecation symptoms identified by using imaging, as dynamic three-dimensional ultrasound and correlate vaginal delivery, parity, and age. OBJECTIVE: The aim of this study was to assess the prevalence of pelvic floor dysfunctions in female patients with obstructed defection symptoms and to determine whether specific pelvic floor dysfunctions identified by dynamic three-dimensional ultrasonography (echodefecography) are correlated with vaginal delivery, parity, and age. The secondary goal is to report the prevalence of coexisting pelvic floor dysfunctions. METHODS: This is a retrospective cohort study including patients with obstructed defecation symptoms underwent echodefecographyto evaluate pelvic floor dysfunctions in the posterior compartment and correlate with vaginal delivery, parity, and age. RESULTS: Of 889 female: 552 (62%) had had vaginal delivery and 337 (38%) were nulliparous. The prevalence of dysfunctions identified by echodefecography (rectocele, intussusception, enterocele/sigmoidocele, and dyssynergia) was similar between the two groups and was not associated with number of deliveriesor age. However, the prevalence of sphincter defects showed higher rates in women with vaginal delivery and increased with the parity. Up to 33% of patients had coexisting dysfunctions. CONCLUSION: The prevalence of dysfunctions such as rectocele, intussusception, dyssynergia, and enterocele/sigmoidocele assessed by echodefecography in patients with obstructed defecation symptoms are found similar regardless of vaginal delivery, number of deliveries or stratified-age. In vaginal delivery, number of deliveries does impact on detection of sphincter defects and liability to fecal incontinence.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 98%

Correlation Between Pelvic Floor Dysfunction on Dynamic 3d Ultrasound and Vaginal Delivery, Parity, and Age in Women With Obstructed Defecation Symptoms

Murad-Regadas

Vilarinho

Borges

et al. 2021

Arq. Gastroenterol.

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“…Median parity was 2 (IQR: 1, 2). The mean age at the first delivery was 23.4 AE 3.0 years (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Significant AI symptoms were found in 29 patients (14.8%) with a mean SMIS of 12.1 AE 4.5 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Resultsmentioning

confidence: 99%

Assessing Obstetric Anal Sphincter Injuries

Zhao

Tang³

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo explore the differences in assessing obstetric anal sphincter injuries (OASI) between transperineal ultrasound (TPUS) and endoanal ultrasound (EAUS) and test relationships between ultrasound findings and anal incontinence (AI) symptoms.MethodsA group of 196 women with a history of vaginal delivery was recruited. OASI was detected in a set of 5 slices by EAUS and 8 slices by TPUS. OASI grading was performed on TPUS rules and EAUS rules. A “significant sphincter defect” was diagnosed by TPUS and EAUS using “2/3 rules.” Symptoms of AI were determined using the St Mark's Incontinence Score (SMIS). Ultrasound findings were compared between the two methods and correlated with symptoms.ResultsOf 196 women, 29 (14.8%) suffered from AI with a mean SMIS of 12.1 ± 4.5, and 70 (35.7%) women with a mean age of 57 years had suspected OASI on imaging. Twenty‐one (10.7%) “significant defects” were diagnosed by TPUS and 24 (12.2%) by EAUS. OASI Grades on TPUS had good agreement with EAUS rules (k = 0.70, P < .001). Logistic regression analysis showed that OASI Grade on imaging and “significant sphincter defects” seen on both forms of imaging were associated with AI symptoms. The odds ratio was 46 and 38 for “significant defects” on TPUS and EAUS, and 14 and 7 for OASI 3b+ on TPUS and EAUS in predicting AI, respectively.Conclusions“Significant defects” diagnosed by EAUS or TPUS and OASI Grade 3b+ predict AI symptoms. The diagnostic performance of endoanal and exoanal ultrasound (EAUS and TPUS) appear to be very similar.

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“…[12,13] Trauma in the anal canal has been detected in approximately 50% of women who performed vaginal delivery. [14] In women who gave birth by C-section, anal fissure is quite low, rating around 1.2-15.2%. [11] In our study, it was found that the vaginal births and its parity affect to anal fissure treatment; a direct relationship was found between the high number of vaginal deliveries and the patients who were not benefiting from medical treatment and going to surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

Bolat

Çakmak

2021

Journal of Contemporary Medicine

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The aim of this study is to examine the effect of obstetric factors on the medical treatment success of anal fissure in women. Material and Method:A total of 324 women, who were diagnosed with anal fissure, who applied to the General Surgery outpatient clinic between 2015 and 2020, were included in the study. The patients were divided into two groups; group I (medical treatment was successful) and group II (medical treatment failed -surgery performed). Both groups were compared in terms of age, body mass index (BMI), number of births, delivery type, birth weight, breastfeeding rate, constipation, diarrhea, smoking and anal fissure symptoms.Results: Medical treatment was applied to all of the 324 patients we included in our study, and it was observed that 45.7% of them had successful medical treatment and 54.3% had undergone surgical treatment (lateral internal sphincterotomy) because of unsuccessful medical treatment. It was found that age, BMI, number of births, number of vaginal births, breastfeeding rate, constipation rates were higher in those who failed medical treatment (p<0.05). The number of cesarean sections, birth weight, diarrhea and smoking were found to be similar between the two groups (p>0.05). While gas incontinence was observed in 44.1% of those who underwent surgical treatment, this rate was found to be 1.4% in those who benefited from medical treatment. Conclusion:In our study, it was found that while maternal age, number of births, vaginal delivery and breastfeeding rates had a negative effect on the success of anal fissure medical treatment, cesarean delivery and baby birth weight were not effective.

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Pubovisceral muscle and anal sphincter defects in women with fecal or urinary incontinence after vaginal delivery

Cited by 10 publications

References 33 publications

Correlation Between Pelvic Floor Dysfunction on Dynamic 3d Ultrasound and Vaginal Delivery, Parity, and Age in Women With Obstructed Defecation Symptoms

Correlation Between Pelvic Floor Dysfunction on Dynamic 3d Ultrasound and Vaginal Delivery, Parity, and Age in Women With Obstructed Defecation Symptoms

Assessing Obstetric Anal Sphincter Injuries

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

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