Anal Sphincter Rupture Research Articles

Pudendal Nerve Damage Increases the Risk of Fecal Incontinence in Women With Anal Sphincter Rupture After Childbirth

Tetzschner, Tine; Sorensen, Michael; Rasmussen, Ole O.; Lose, Gunnar; Christiansen, JohnAuthor Information

Incontinence Following Rupture of the Anal Sphincter During Delivery

To determine the frequency with which patients report incontinence of flatus or stool after rupture of the anal sphincter during delivery. A chart review and telephone interview were conducted with 70 primiparas, 35 of whom had rupture of the anal sphincter at delivery and 35 of whom did not. All were contacted 9-12 months postpartum and questioned about the development of incontinence of gas or liquid or formed stool, persistent dyspareunia, and perineal pain. Incontinence of gas was reported by six women (17%) in the rupture group and one (3%) in the control group (P < .05). The incidence of incontinence of stool, both liquid and solid, dyspareunia, and persistent perineal pain were similar between the groups. Incontinence of flatus was reported six times more often by women who experienced a third- or fourth-degree perineal laceration than by those without anal sphincter rupture.

Anal sphincter function after delivery: a prospective study in women with sphincter rupture and controls

Twenty-one consecutive women with anal sphincter muscle rupture during delivery (0.79%) and 15 controls were examined. The anal sphincter was immediately repaired in the study group and the function determined with anal profilometry at 3 days and 3 months after delivery, and in ten of the patients after 12 months. Anal sphincter strength was reduced soon after delivery in the controls but regained normal strength within 3 months. In the anal sphincter rupture group, an improvement was found over the first 3 months after delivery, but afterwards no further change occurred. The anal sphincter strength was significally reduced compared to the control group, both soon after delivery and after 3 months. Their voluntary anal pressure increased from 1.7 kPa immediately after delivery to 3.2 kPa at 3 months in the study group and the corresponding values in the control group were 4.0 and 6.5 kPa, respectively. For the closing pressure, that is the resting pressure minus the rectal pressure, the values in the study group were 4.2 and 6.7 kPa, and in the control group 7.2 and 9.4 kPa, respectively. In the women with anal sphincter rupture, however, a significantly increased frequency of gas incontinence was found.

Successful Late Repair Of Anal Sphincter Rupture Caused By Delivery

Successful surgical treatment of anal incontinence due to anal sphincter rupture of 14 years duration is described. Objective evaluations were performed with anal profilometry.

Successful Late Repair of Anal Sphincter Rupture Caused by Delivery

Successful Late Repair of Anal Sphincter Rupture Caused by Delivery

Long-term ailments due to anal sphincter rupture caused by delivery — a hidden problem

Questionnaires concerning ailments were sent postpartum (mean two years) to 62 women with anal sphincter ruptures (ASR), who were compared with a matched control population. The frequency of anal sphincter rupture at the hospital during delivery in the period, 1978-82, was 0.7% (n = 63). Primiparity, instrumental deliveries, abnormal presentation, large babies and oxytocin stimulation were all risk factors. Of 59 women answering the questionnaire 37 (63%) stated that they had had ailments three months postpartum, mainly with pain and involuntary passage of flatus but also with dyspareunia and occasional incontinence of faeces. Long-term symptoms were noted by 28 (48%) of the women, mainly with involuntary passage of flatus but also perineal pain, dyspareunia and occasional incontinence of faeces. Long-term symptoms occurred in 7 (88%) of women with ASR also involving the anal mucosa, but only in 21 (39%) of those with ASR only. Three of the patients subsequently underwent reconstructive surgery, and three complained of psychological problems.