A modified surgical approach to women with obstetric anal sphincter tears by separate suturing of external and internal anal sphincter. A modified approach to obstetric anal sphincter injury

BMC Pregnancy and Childbirth

Research Article

Mats Jernetz¹  Pelle G Lindqvist² 

[1] Departments of Obstetrics and Gynecology, Clinical Science, Malmö University Hospital MAS, 20502, Malmö, Sweden;Departments of Obstetrics and Gynecology, Clintech, Karolinska University Hospital, 14186, Huddinge, Huddinge, Sweden;

关键词: Anal Sphincter;    External Anal Sphincter;    Anal Incontinence;    Posterior Vaginal Wall;    Obstetric Anal Sphincter Injury;   

DOI  :  10.1186/1471-2393-10-51

 received in 2009-09-08, accepted in 2010-09-09,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundLong-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence.MethodsIn a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sphincter muscles with monofilament absorbable sutures. The principal outcome assessed by answers given to six questions, was a difference in anal incontinence score, between the study group and two control groups (women with prior OASI [n = 180] and primiparous women delivered vaginally without a diagnose of OASI [n = 100]).ResultsAn anal incontinence score of zero (i.e., no symptoms) was found in 74% of the study group, 47% of the OASI control group, and 66% of the vaginal control group (p = 0.02 and 0.5, as compared to the study group).ConclusionsA modified suturing technique was followed by significant improved one-year symptoms of anal incontinence as compared to historical cases.

【 授权许可】

CC BY   
© Lindqvist and Jernetz; licensee BioMed Central Ltd. 2010