Obstetrical Anal Sphincter Laceration and Anal Incontinence 5-10 Years After Childbirth

Overview

Journal Am J Obstet Gynecol

Publisher Elsevier

Specialty Gynecology & Obstetrics

Date 2012 Jul 27

PMID 22831810

Citations 26

Authors

Emily C Evers

Joan L Blomquist

Kelly C McDermott

Victoria L Handa

Affiliations

Soon will be listed here.

Abstract

Objective: The purpose of this study was to investigate the long-term impact of anal sphincter laceration on anal incontinence.

Study Design: Five to 10 years after first delivery, anal incontinence and other bowel symptoms were measured with the Epidemiology of Prolapse and Incontinence Questionnaire and the short form of the Colorectal-Anal Impact Questionnaire. Obstetric exposures were assessed with review of hospital records. Symptoms and quality-of-life impact were compared among 90 women with at least 1 anal sphincter laceration, 320 women who delivered vaginally without sphincter laceration, and 527 women who delivered by cesarean delivery.

Results: Women who sustained an anal sphincter laceration were most likely to report anal incontinence (odds ratio, 2.32; 95% confidence interval, 1.27-4.26) and reported the greatest negative impact on quality of life. Anal incontinence and quality-of-life scores were similar between women who delivered by cesarean section and those who delivered vaginally without sphincter laceration.

Conclusion: Anal sphincter laceration is associated with anal incontinence 5-10 years after delivery.

Citing Articles

Educational efficacy of the simulation-based episiotomy training: a multi-center observational study.

Zhong Z, Lu Y, Pu Y, Luo Q, Zhao B BMC Med Educ. 2025; 25(1):347.

PMID: 40050857 PMC: 11887089. DOI: 10.1186/s12909-025-06887-4.

The outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience.

Arcieri M, Battello G, Graziano A, Alfare Lovo M, Restaino S, DAntonio F Arch Gynecol Obstet. 2025; .

PMID: 39869199 DOI: 10.1007/s00404-024-07906-3.

Obstetric Anal Sphincter Injury Care Bundle: A Quality Improvement Initiative.

Powell T, Hoke T, Norris K, Page M, Todd A, Redden D Int Urogynecol J. 2024; 35(11):2125-2130.

PMID: 39331149 PMC: 11638415. DOI: 10.1007/s00192-024-05885-2.

How to Avoid Becoming a Risk Factor of Fecal Incontinence Due to OASIS-A Narrative Review.

Horst N J Clin Med. 2024; 13(17).

PMID: 39274283 PMC: 11395989. DOI: 10.3390/jcm13175071.

Retrospective Case-Control Study of Extended Birth Perineal Tears and Risk Factors.

Dendini M, Aldossari S, AlQassab H, Aldraihem O, Almalki A Cureus. 2024; 16(3):e57132.

PMID: 38681371 PMC: 11055567. DOI: 10.7759/cureus.57132.

References

Macmillan A, Merrie A, Marshall R, Parry B . The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum. 2004; 47(8):1341-9. DOI: 10.1007/s10350-004-0593-0. View

Handa V, Blomquist J, McDermott K, Friedman S, Munoz A . Pelvic floor disorders after vaginal birth: effect of episiotomy, perineal laceration, and operative birth. Obstet Gynecol. 2012; 119(2 Pt 1):233-9. PMC: 3266992. DOI: 10.1097/AOG.0b013e318240df4f. View

Borello-France D, Burgio K, Richter H, Zyczynski H, Fitzgerald M, Whitehead W . Fecal and urinary incontinence in primiparous women. Obstet Gynecol. 2006; 108(4):863-72. DOI: 10.1097/01.AOG.0000232504.32589.3b. View

Kammerer-Doak D, Wesol A, Rogers R, Dominguez C, Dorin M . A prospective cohort study of women after primary repair of obstetric anal sphincter laceration. Am J Obstet Gynecol. 1999; 181(6):1317-22; discussion 1322-3. DOI: 10.1016/s0002-9378(99)70370-4. View

Fenner D, Genberg B, Brahma P, Marek L, DeLancey J . Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol. 2004; 189(6):1543-9. DOI: 10.1016/j.ajog.2003.09.030. View

Johanson J, Lafferty J . Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol. 1996; 91(1):33-6. View

Nordenstam J, Altman D, Brismar S, Zetterstrom J . Natural progression of anal incontinence after childbirth. Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20(9):1029-35. DOI: 10.1007/s00192-009-0901-2. View

Lukacz E, Lawrence J, Buckwalter J, Burchette R, Nager C, Luber K . Epidemiology of prolapse and incontinence questionnaire: validation of a new epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 16(4):272-84. DOI: 10.1007/s00192-005-1314-5. View

Handa V, Blomquist J, Knoepp L, Hoskey K, McDermott K, Munoz A . Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth. Obstet Gynecol. 2011; 118(4):777-84. PMC: 3178744. DOI: 10.1097/AOG.0b013e3182267f2f. View

10.

Bols E, Hendriks E, Berghmans B, Baeten C, Nijhuis J, de Bie R . A systematic review of etiological factors for postpartum fecal incontinence. Acta Obstet Gynecol Scand. 2010; 89(3):302-14. DOI: 10.3109/00016340903576004. View

11.

Barber M, Walters M, Bump R . Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005; 193(1):103-13. DOI: 10.1016/j.ajog.2004.12.025. View

12.

Rice F, Lewis A, Harold G, van den Bree M, Boivin J, Hay D . Agreement between maternal report and antenatal records for a range of pre and peri-natal factors: the influence of maternal and child characteristics. Early Hum Dev. 2006; 83(8):497-504. DOI: 10.1016/j.earlhumdev.2006.09.015. View

13.

Melville J, Fan M, Newton K, Fenner D . Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol. 2005; 193(6):2071-6. DOI: 10.1016/j.ajog.2005.07.018. View

14.

Van Brummen H, Bruinse H, van de Pol G, Heintz A, Huub van der Vaart C . Defecatory symptoms during and after the first pregnancy: prevalences and associated factors. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 17(3):224-30. DOI: 10.1007/s00192-005-1351-0. View

15.

Faltin D, Otero M, Petignat P, Sangalli M, Floris L, Boulvain M . Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence. Am J Obstet Gynecol. 2006; 194(5):1255-9. DOI: 10.1016/j.ajog.2005.10.797. View

16.

Bagade P, Mackenzie S . Outcomes from medium term follow-up of patients with third and fourth degree perineal tears. J Obstet Gynaecol. 2010; 30(6):609-12. DOI: 10.3109/01443615.2010.494205. View

17.

Elkadry E, Kenton K, White P, Creech S, Brubaker L . Do mothers remember key events during labor?. Am J Obstet Gynecol. 2003; 189(1):195-200. DOI: 10.1067/mob.2003.371. View

18.

Baud D, Meyer S, Vial Y, Hohlfeld P, Achtari C . Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery. Int Urogynecol J. 2011; 22(9):1127-34. DOI: 10.1007/s00192-011-1431-2. View