Anatomic and functional results of surgical repair after total perineal rupture at delivery.

Laceration of the perineum during delivery might sever the anal sphincter and result in discomfort, pain and even anal incontinence. We reviewed the degree of incontinence after repair of the anal sphincter in 20 female patients with complete third degree lacerations after delivery. In addition, anal manometry was performed upon seven patients. The resting and squeeze pressures were measured. At the same time, single needle electromyography of the external sphincter muscle was recorded. An uneventful recovery was found in all patients. This was confirmed by restoration of the anal pressures of voluntary and involuntary control within low to low normal limits indicating an almost complete anatomic recovery of the anal sphincter complex. Three patients had complaints of incontinence. These complaints were often neglected by both the obstetrician and patient. In these patients, anal manometric measurements together with single needle electromyography of the external anal sphincter muscle were not useful diagnostic methods for determining anal incontinence.