Document Detail

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.
MedLine Citation:
PMID:  22955309     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  120     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-21     Completed Date:  2013-01-24     Revised Date:  2013-02-08    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  803-8     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, Dalhousie University Halifax, Halifax, Nova Scotia, Canada.
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MeSH Terms
Anal Canal / injuries*,  surgery
Fecal Incontinence / epidemiology,  etiology,  prevention & control*
Follow-Up Studies
Logistic Models
Obstetric Labor Complications / surgery*
Perineum / injuries,  surgery
Postoperative Complications / epidemiology,  etiology,  prevention & control*
Single-Blind Method
Suture Techniques*
Treatment Outcome
Grant Support
//Canadian Institutes of Health Research
Erratum In:
Obstet Gynecol. 2012 Dec;120(6):1482

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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