Catherine M Nichols1, Elizabeth H Lamb, Viswanathan Ramakrishnan. 1. Department of Obstetrics and Gynecology, Medical College of Virginia/Virginia Commonwealth University Medical Center, Richmond, VA 23298-0034, USA. cmnichol@hsc.vcu.edu
Abstract
OBJECTIVE: The purpose of this study was to compare outcomes after third- versus fourth-degree laceration repair. STUDY DESIGN: Fifty-six primiparous women who sustained a third- or fourth-degree tear were enrolled at delivery and demographic and obstetric data were collected. At 6 weeks' postpartum, subjects completed a bowel function questionnaire and endoanal ultrasonography was performed. Fisher exact test and chi-square were used for statistical analysis. RESULTS: Thirty-nine women with third- and 17 with fourth-degree tears were enrolled. Subjects with fourth- were more likely to report bowel symptoms (59% vs 28%, P = .03), and to demonstrate persistent combined defects of the internal (IAS) and external anal sphincter (EAS) (48% vs 8%, P = .002) than third-degree tears. Combined defects were associated with the highest risk of bowel symptoms (OR 18.7, 95% CI 3-101, P < .001). CONCLUSION: Bowel symptoms were more common after fourth- than third-degree repair, and may be secondary to higher rates of combined defects of the IAS and EAS.
OBJECTIVE: The purpose of this study was to compare outcomes after third- versus fourth-degree laceration repair. STUDY DESIGN: Fifty-six primiparous women who sustained a third- or fourth-degree tear were enrolled at delivery and demographic and obstetric data were collected. At 6 weeks' postpartum, subjects completed a bowel function questionnaire and endoanal ultrasonography was performed. Fisher exact test and chi-square were used for statistical analysis. RESULTS: Thirty-nine women with third- and 17 with fourth-degree tears were enrolled. Subjects with fourth- were more likely to report bowel symptoms (59% vs 28%, P = .03), and to demonstrate persistent combined defects of the internal (IAS) and external anal sphincter (EAS) (48% vs 8%, P = .002) than third-degree tears. Combined defects were associated with the highest risk of bowel symptoms (OR 18.7, 95% CI 3-101, P < .001). CONCLUSION:Bowel symptoms were more common after fourth- than third-degree repair, and may be secondary to higher rates of combined defects of the IAS and EAS.
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: Kanoe-Lehua de Silva; Pai-Jong Stacy Tsai; Leanne M Kon; Mark Hiraoka; Bruce Kessel; Todd Seto; Bliss Kaneshiro Journal: Hawaii J Med Public Health Date: 2014-03
Authors: Juan A Barca; Coral Bravo; Santiago García Tizón; Rocío Aracil-Rodriguez; Juan Manuel Pina-Moreno; Ignacio Cueto-Hernández; Maria P Pintado-Recarte; Melchor Alvarez-Mon; Miguel A Ortega; Juan A De León-Luis Journal: Int J Environ Res Public Health Date: 2022-09-13 Impact factor: 4.614
Authors: Annette J Reid; Andrew D Beggs; Abdul H Sultan; Anne-Marie Roos; Ranee Thakar Journal: Int J Gynaecol Obstet Date: 2014-06-12 Impact factor: 3.561