Postpartum anal sphincter injury – overlap suturing. Case report

Abstract

Injury to the anal sphincter is a challenging clinical problem that may be encountered by any doctor in their daily practice. The most common injuries are associated with complicated childbirth, traffic accidents and impalement-type injuries. Depending on their course, injuries with or without sphincter muscle disruption have been distinguished. We present a case of obstetric trauma in a primiparous woman aged 25 years with grade 3 perineal tear. The injury was repaired within 2 hours of delivery. The muscles were sutured using the overlap method with good functional and cosmetic outcomes. The patient reported no symptoms of incontinence in the following weeks after the injury, the anus was compact. A follow-up proctological examination showed normal sphincter tone and function. We would like to emphasise the importance of regular training in practical proctological knowledge. The ability to repair such a challenging injury requires continuous proctological practice. Grade 3-4 perineal injuries are relatively rare, most commonly managed by obstetric gynaecologists. Therefore, it is often impossible to acquire skills in this area as part of daily surgical practice.