Document Detail


Outcome of primary repair of obstetric anal sphincter rupture using the overlap technique.
MedLine Citation:
PMID:  17943465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Grade III and IV anal sphincter ruptures after vaginal delivery are an increasing problem. We assessed the outcome of an overlap technique in primary repair. METHODS: In this retrospective observational study, from 2002 to 2004, 61 consecutive women with grade III and IV obstetric tears were included. Of the 61 women, 42 had complete rupture of the external sphincter and underwent sphincter repair using standardised overlap technique. The outcome was assessed by clinical examination, Wexner questionnaire, and endoanal ultrasonography (EAUS), after a median follow-up of 9.4 months. Main outcome measure was continence following primary repair. RESULTS: At follow-up, 64% of the patients had no symptoms of anal incontinence. A total of 29% experienced occasional incontinence to flatus, 1 patient (2%) experienced occasional incontinence to liquid stools, and 1 patient to liquid or normal stools. EAUS revealed intact external sphincter in 29 of the 35 patients (83%). In 6 patients (17%), EAUS showed partial discontinuity of the sphincter muscle. CONCLUSION: The results show that the primary overlap technique in the repair of anal sphincter rupture following vaginal delivery is highly successful.
Authors:
Pontus Molander; Tapio Väyrynen; Jorma Paavonen; Anna Lepistö; Pekka Luukkonen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-10-16
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  86     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2007  
Date Detail:
Created Date:  2007-11-21     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1458-62     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Jorvi Hospital, Espoo, Finland. pontus.molander@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / injuries*,  surgery*
Episiotomy / adverse effects
Fecal Incontinence / epidemiology*,  etiology,  pathology,  surgery
Female
Finland / epidemiology
Humans
Manometry
Middle Aged
Outcome Assessment (Health Care)*
Postoperative Complications
Pregnancy
Puerperal Disorders / epidemiology*,  etiology,  pathology,  surgery
Questionnaires
Rupture / surgery
Severity of Illness Index
Vacuum Extraction, Obstetrical / adverse effects

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