A surgical technique for secondary repair of obstetric anal sphincter injuries; sphinctero-vagino-perineoplasty.

Arife Şimsek,Mustafa Ateş,Abuzer Dirican,Dinçer Özgör

doi:10.4274/tjod.12369

Abstract

Objective:This study was conducted to present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of obstetric anal sphincter injuries.Materials and Methods:This retrospective study was conducted on the records of seven patients who underwent secondary repair of obstetric anal sphincter injuries at the colorectal surgery unit of a tertiary care center between February 2015 and December 2017.Results:All patients with solid stool incontinence were fully recovered at postoperative month 3. The Wexner incontinence score was significantly improved (decreased from 14.12 [range: 8-20] to 2.28 [range: 1-4]). The complication rate was 85.7% (wound infection, abscess, hematoma, detachment).Conclusion:Combined repair of anal sphinchters, perineal body, superficial transverse perineal muscles, and bulbospongious muscles, which contribute to anal continence, may improve surgical outcomes in patients with obstetric anal sphincter injuries.

Highlights

The most common cause of anal incontinence in women is obstetric anal sphincter injuries (OASIS)
When OASIS is treated for anal incontinence, it is considered as a secondary repair even if no primary repair has been performed during the postpartum period[4]
There is no consensus on which surgical technique is PRECIS: We present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of OASIS

Summary

Introduction

The most common cause of anal incontinence in women is obstetric anal sphincter injuries (OASIS). Apparent OASIS occur in less than 3 percent of vaginal deliveries[1]. In spite of primary repair, up to 5% of these patients develop anal incontinence, which severely impairs their quality of life[2,3]. When OASIS is treated for anal incontinence, it is considered as a secondary repair even if no primary repair has been performed during the postpartum period[4]. There is no consensus on which surgical technique is PRECIS: We present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of OASIS

Methods

Results

Discussion

Conclusion