Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Frudinger, A; Ballon, M; Taylor, SA; Halligan, S.
The natural history of clinically unrecognized anal sphincter tears over 10 years after first vaginal delivery.
Obstet Gynecol. 2008; 111(5):1058-1064
Doi: 10.1097/AOG.0b013e31816c4433
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PubMed
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- Führende Autor*innen der Med Uni Graz
- Frudinger Andrea
- Co-Autor*innen der Med Uni Graz
- Ballon Martina Gabriele
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- Abstract:
- OBJECTIVE: To estimate the influence of clinically unrecognized anal sphincter injuries detected by endoanal ultrasonography 3 months after first vaginal delivery on symptoms of anal incontinence over the subsequent 10-year period. METHODS: One-hundred fifty-six consecutive primigravid women were recruited, anal endosonography performed, and bowel habit predelivery characterized by means of a validated 24-point questionnaire. After excluding four women with a clinically recognized sphincter tear after delivery and 18 who delivered by cesarean, these procedures were repeated 3 months postpartum. The questionnaire was repeated at 5 and 10 years to estimate continence change over the decade after delivery. Logistic regression was used to examine the effect of clinically unrecognized sphincter tears on continence. RESULTS: After delivery, continence deteriorated from baseline in 37 (28%) women, eight of whom had anal sphincter tears. Continence did not deteriorate in 97 women, six of whom had anal sphincter tears. At 10 years, 59 (55%) of 107 contactable women had continence scores greater than zero, 23 of whom had deteriorated from baseline. There was a significant relationship between a sphincter tear that was symptomatic after delivery and continence deterioration sustained at 5 and 10 years (odds ratio 2.8 for change in continence score). However, no relationship was found over 10 years for those women who sustained a sphincter tear but whose continence did not deteriorate postpartum. CONCLUSION: Ultrasonographic anal sphincter defects without postpartum incontinence are not associated with deterioration in continence over the following decade. LEVEL OF EVIDENCE: II.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Anal Canal - injuries
- Delivery, Obstetric - adverse effects
- Endosonography -
- Fecal Incontinence - epidemiology
- Female -
- Follow-Up Studies -
- Humans -
- Incidence -
- Lacerations - diagnosis
- Logistic Models -
- Odds Ratio -
- Questionnaires -