OBJECTIVE: To determine the influence of parity and method of primary anal sphincter repair on outcome following obstetrical third degree perineal tear. STUDY DESIGN: Prospective study of 154 women after primary repair following third degree tear conducted over 2 years. Postpartum evaluation included a continence questionnaire, anal manometry and endoanal ultrasound. RESULTS: Third degree tears occurred in 1.6% primiparae and 0.6% multiparae during the study period; in 42/112 (38%) primiparae and 10/42 (24%) multiparae, these tears occurred at instrumental deliveries. Mean birthweight (3.8+/-0. 43 kg) was similar in both groups, but prolonged latent second stage of labour (P=0.003), use of epidural analgesia (P<0.0001) and episiotomy extension (P1 quadrant) anal sphincter defect. CONCLUSION: Outcome of anal sphincter repair was not influenced by parity or mode of repair. Despite good symptomatic outcomes, ultrasound evidence of significant anal sphincter injury was found in one-third of patients.
OBJECTIVE: To determine the influence of parity and method of primary anal sphincter repair on outcome following obstetrical third degree perineal tear. STUDY DESIGN: Prospective study of 154 women after primary repair following third degree tear conducted over 2 years. Postpartum evaluation included a continence questionnaire, anal manometry and endoanal ultrasound. RESULTS: Third degree tears occurred in 1.6% primiparae and 0.6% multiparae during the study period; in 42/112 (38%) primiparae and 10/42 (24%) multiparae, these tears occurred at instrumental deliveries. Mean birthweight (3.8+/-0. 43 kg) was similar in both groups, but prolonged latent second stage of labour (P=0.003), use of epidural analgesia (P<0.0001) and episiotomy extension (P1 quadrant) anal sphincter defect. CONCLUSION: Outcome of anal sphincter repair was not influenced by parity or mode of repair. Despite good symptomatic outcomes, ultrasound evidence of significant anal sphincter injury was found in one-third of patients.
Authors: Holly E Richter; Charles W Nager; Kathryn L Burgio; Ryan Whitworth; Alison C Weidner; Joseph Schaffer; Halina M Zyczynski; Peggy Norton; John Eric Jelovsek; Susan F Meikle; Cathie Spino; Marie Gantz; Scott Graziano; Linda Brubaker Journal: Female Pelvic Med Reconstr Surg Date: 2015 Jul-Aug Impact factor: 2.091
Authors: Abimbola Williams; Elisabeth J Adams; Jill Bolderson; Douglas G Tincello; David H Richmond Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2003-11-25
Authors: Ruwan J Fernando; Abdul H Sultan; Simon Radley; Peter W Jones; Richard B Johanson Journal: BMC Health Serv Res Date: 2002-05-13 Impact factor: 2.655