A modified surgical approach to women with obstetric anal sphincter tears by separate suturing of external and internal anal sphincter. A modified approach to obstetric anal sphincter injury.

Abstract:

BACKGROUND:Long-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence. METHODS:In a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sphincter muscles with monofilament absorbable sutures. The principal outcome assessed by answers given to six questions, was a difference in anal incontinence score, between the study group and two control groups (women with prior OASI [n = 180] and primiparous women delivered vaginally without a diagnose of OASI [n = 100]). RESULTS:An anal incontinence score of zero (i.e., no symptoms) was found in 74% of the study group, 47% of the OASI control group, and 66% of the vaginal control group (p = 0.02 and 0.5, as compared to the study group). CONCLUSIONS:A modified suturing technique was followed by significant improved one-year symptoms of anal incontinence as compared to historical cases.

authors

Lindqvist PG,Jernetz M

doi

10.1186/1471-2393-10-51

subject

Has Abstract

pub_date

2010-09-09 00:00:00

pages

51

issn

1471-2393

pii

1471-2393-10-51

journal_volume

10

pub_type

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