| Overlapping compared with end-to-end repair of complete third-degree or fourth-degree obstetric tears: three-year follow-up of a randomized controlled trial. | |
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MedLine Citation:
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PMID: 22955309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To report on a 3-year follow-up of women who underwent overlapping repair of a complete third-degree or fourth-degree obstetric tear. METHODS: Primiparous women sustaining a complete third-degree or a fourth-degree tear of the perineum were randomized to a primary sphincter repair using either an end-to-end or an overlapping surgical technique. At 1, 2, and 3 years, questionnaires on rates of flatal and fecal incontinence were mailed to participants. RESULTS: At 1 year, women who underwent an end-to-end repair reported lower rates of flatal and fecal incontinence than women who had an overlapping repair. For flatal incontinence the rates were 31% compared with 56% (95% confidence interval for the rate difference 6-43%, P=.012). For fecal incontinence, the rates were 7% compared with 16% (95% confidence interval for the rate difference -4% to 21%, P=.17). The difference between the two methods of surgical repair had largely disappeared by the end of year 2. CONCLUSION: At 1-year follow-up, end-to-end repair of complete third-degree or fourth-degree obstetric anal sphincter tears is associated with significantly lower rates of anal incontinence when compared with overlapping repair. There is no long-term benefit associated with either technique over the other. CLINICAL TRIAL REGISTRATION: ISRCTN Register, http://isrctn.org, ISRCTNO 4149919. LEVEL OF EVIDENCE: I. |
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Authors:
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Scott A Farrell; Gordon Flowerdew; Donna Gilmour; Geoffrey K Turnbull; Matthias H Schmidt; Thomas F Baskett; Cora A Fanning |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 120 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-21 Completed Date: 2013-01-24 Revised Date: 2013-02-08 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 803-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Dalhousie University Halifax, Halifax, Nova Scotia, Canada. scott.farrell@iwk.nshealth.ca |
| Data Bank Information | |
Bank Name/Acc. No.:
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ISRCTN/ISRCTN04149919 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anal Canal / injuries*, surgery Fecal Incontinence / epidemiology, etiology, prevention & control* Female Follow-Up Studies Humans Logistic Models Obstetric Labor Complications / surgery* Perineum / injuries, surgery Postoperative Complications / epidemiology, etiology, prevention & control* Pregnancy Questionnaires Single-Blind Method Suture Techniques* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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//Canadian Institutes of Health Research |
| Comments/Corrections | |
Erratum In:
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Obstet Gynecol. 2012 Dec;120(6):1482 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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