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Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway

BACKGROUND: Aim of the study was to estimate the prevalence of postpartum anal incontinence among women who delivered vaginally, and to assess the extent to which obstetric injuries to the anal sphincters are missed. METHODS: All women (both primiparous and multiparous) who delivered vaginally and r...

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Autores principales: Berg, Matilde Risopatron, Sahlin, Ylva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310077/
https://www.ncbi.nlm.nih.gov/pubmed/32571291
http://dx.doi.org/10.1186/s12905-020-00989-5
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author Berg, Matilde Risopatron
Sahlin, Ylva
author_facet Berg, Matilde Risopatron
Sahlin, Ylva
author_sort Berg, Matilde Risopatron
collection PubMed
description BACKGROUND: Aim of the study was to estimate the prevalence of postpartum anal incontinence among women who delivered vaginally, and to assess the extent to which obstetric injuries to the anal sphincters are missed. METHODS: All women (both primiparous and multiparous) who delivered vaginally and received any kind of sutures in the perineal area at Innlandet Hospital Trust Elverum in Norway between January 1, 2015 and June 30, 2016 were invited to answer a questionnaire on St. Mark’s incontinence score and to participate in a clinical examination of the pelvic floor including endoanal sonography. RESULTS: In total 52,3% (n = 207) of the 396 invited women participated in the study. Mean St. Mark’s score was 1.8 points (95% CI 1.4 to 2.1) at examination 14 months (mean) postpartum, and none of the participants suffered from weekly fecal leakage. Fecal urgency affected 11.7% (95% CI 7.1 to 16.3) of the participants, and 8.7% (95%CI 5.1 to 12.8) had weekly involuntary leakage of flatus. Nine women (9.3%, 95% CI 4.1 to 15.5) had a previously undetected third degree obstetric anal sphincter injury. CONCLUSION: The prevalence of anal incontinence among women who have delivered vaginally and received sutures due to 1st and 2nd degree perineal lacerations is low. Some obstetric anal sphincter injuries remain unrecognized at the time of delivery, but the symptoms of anal incontinence due to these injuries are in the lower half of the St. Mark’s incontinence score. Women with persistent symptoms like fecal urgency or leakage of gas and/or feces should be referred to evaluation by a colorectal surgeon in order to achieve optimal treatment.
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spelling pubmed-73100772020-06-23 Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway Berg, Matilde Risopatron Sahlin, Ylva BMC Womens Health Research Article BACKGROUND: Aim of the study was to estimate the prevalence of postpartum anal incontinence among women who delivered vaginally, and to assess the extent to which obstetric injuries to the anal sphincters are missed. METHODS: All women (both primiparous and multiparous) who delivered vaginally and received any kind of sutures in the perineal area at Innlandet Hospital Trust Elverum in Norway between January 1, 2015 and June 30, 2016 were invited to answer a questionnaire on St. Mark’s incontinence score and to participate in a clinical examination of the pelvic floor including endoanal sonography. RESULTS: In total 52,3% (n = 207) of the 396 invited women participated in the study. Mean St. Mark’s score was 1.8 points (95% CI 1.4 to 2.1) at examination 14 months (mean) postpartum, and none of the participants suffered from weekly fecal leakage. Fecal urgency affected 11.7% (95% CI 7.1 to 16.3) of the participants, and 8.7% (95%CI 5.1 to 12.8) had weekly involuntary leakage of flatus. Nine women (9.3%, 95% CI 4.1 to 15.5) had a previously undetected third degree obstetric anal sphincter injury. CONCLUSION: The prevalence of anal incontinence among women who have delivered vaginally and received sutures due to 1st and 2nd degree perineal lacerations is low. Some obstetric anal sphincter injuries remain unrecognized at the time of delivery, but the symptoms of anal incontinence due to these injuries are in the lower half of the St. Mark’s incontinence score. Women with persistent symptoms like fecal urgency or leakage of gas and/or feces should be referred to evaluation by a colorectal surgeon in order to achieve optimal treatment. BioMed Central 2020-06-22 /pmc/articles/PMC7310077/ /pubmed/32571291 http://dx.doi.org/10.1186/s12905-020-00989-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Berg, Matilde Risopatron
Sahlin, Ylva
Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway
title Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway
title_full Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway
title_fullStr Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway
title_full_unstemmed Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway
title_short Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in Norway
title_sort anal incontinence and unrecognized anal sphincter injuries after vaginal delivery– a cross-sectional study in norway
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310077/
https://www.ncbi.nlm.nih.gov/pubmed/32571291
http://dx.doi.org/10.1186/s12905-020-00989-5
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