K Ramalingam1, A K Monga. 1. Kingston Hospital NHS trust, Galsworthy Road, Kingston, Surrey, KT2 7QB, UK. kalaivani5@yahoo.com
Abstract
INTRODUCTION AND HYPOTHESIS: To determine if the classification of obstetric anal sphincter injuries (OASIs) affected clinical and functional outcome and to assess the need for follow-up of 3a tears in secondary care METHODS: Prospective data collection in 255 patients who sustained OASIs during repair with follow-up in a specialist clinic after 6 months. RESULTS: One hundred and thirty-two patients (51.7 %) sustained 3a tears, 81 (31.7 %) 3b tears, 27 (10.6 %) 3c tears and 15 (5.8 %) had 4th degree tears. Twenty-three patients (9 %) reported symptoms at 6-month follow-up. Eight patients reported anal incontinence of liquid or solid stool. Among patients who sustained 3a tears, 8 patients were symptomatic: 7 had urgency and 1 had flatus incontinence. None of the patients who sustained 3a tears reported incontinence of solid/liquid stool. There appears to be no correlation with scan findings and symptoms at follow up. Most patients are asymptomatic. Urgency of faeces is the commonest symptom. CONCLUSIONS: The vast majority of patients are asymptomatic. The necessity of seeing all these patients in secondary care for follow-up needs to be questioned. With effective primary care follow-up, there may be a place to follow up patients with 3a tears in the community during the routine 6-week postnatal check and refer the symptomatic patients to the hospital for further review.
INTRODUCTION AND HYPOTHESIS: To determine if the classification of obstetric anal sphincter injuries (OASIs) affected clinical and functional outcome and to assess the need for follow-up of 3a tears in secondary care METHODS: Prospective data collection in 255 patients who sustained OASIs during repair with follow-up in a specialist clinic after 6 months. RESULTS: One hundred and thirty-two patients (51.7 %) sustained 3a tears, 81 (31.7 %) 3b tears, 27 (10.6 %) 3c tears and 15 (5.8 %) had 4th degree tears. Twenty-three patients (9 %) reported symptoms at 6-month follow-up. Eight patients reported anal incontinence of liquid or solid stool. Among patients who sustained 3a tears, 8 patients were symptomatic: 7 had urgency and 1 had flatus incontinence. None of the patients who sustained 3a tears reported incontinence of solid/liquid stool. There appears to be no correlation with scan findings and symptoms at follow up. Most patients are asymptomatic. Urgency of faeces is the commonest symptom. CONCLUSIONS: The vast majority of patients are asymptomatic. The necessity of seeing all these patients in secondary care for follow-up needs to be questioned. With effective primary care follow-up, there may be a place to follow up patients with 3a tears in the community during the routine 6-week postnatal check and refer the symptomatic patients to the hospital for further review.
Authors: Hannah G Krause; Barbara A Hall; Shu-Kay Ng; Harriet Natukunda; Isaac Singasi; Judith T W Goh Journal: Int Urogynecol J Date: 2016-11-07 Impact factor: 2.894
Authors: Malou Barbosa; Peter Christensen; Karl Møller-Bek; Lise Brogaard; Marianne Glavind-Kristensen Journal: Int Urogynecol J Date: 2021-03-17 Impact factor: 2.894
Authors: Judith T W Goh; Stephanie B M Tan; Harriet Natukunda; Isaac Singasi; Hannah G Krause Journal: Int Urogynecol J Date: 2016-04-30 Impact factor: 2.894