| Primary repair of obstetric anal sphincter rupture using the overlap technique. | |
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MedLine Citation:
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PMID: 10426237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the feasibility of a new technique of primary overlap anal sphincter repair instead of end-to-end repair. SETTING: A teaching hospital and a district general hospital. METHODS: Between June 1995 and November 1996, two obstetricians repaired 32 anal sphincters ruptured during vaginal delivery. A ruptured internal sphincter was repaired separately and the torn ends of the external sphincter were overlapped and sutured with 3/0 polydioxanone sulphate sutures (Ethicon, Edinburgh, UK). MAIN OUTCOME MEASURES: Bowel function, clinical assessment, anal endosonography and manometry performed at a mean of 140 days after delivery. RESULTS: Eight percent of the women experienced incontinence of flatus. Fifteen percent had persistent sonographic external sphincter defects, and 44% had internal sphincter defects. The maximum mean resting pressure was 58 mmHg (range 37-135) and the mean maximum incremental squeeze pressure 54 mmHg (range 8-104). None had defaecatory difficulty and no complications were encountered with the new technique of repair. CONCLUSIONS: Reservations regarding the feasibility of the overlap technique of primary repair are unfounded, as both subjective and objective outcomes are favourable compared with other studies using end-to-end approximation. A multicentre randomised study of the overlap vs end-to-end repair technique is now planned. |
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Authors:
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A H Sultan; A K Monga; D Kumar; S L Stanton |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study |
Journal Detail:
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Title: British journal of obstetrics and gynaecology Volume: 106 ISSN: 0306-5456 ISO Abbreviation: Br J Obstet Gynaecol Publication Date: 1999 Apr |
Date Detail:
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Created Date: 1999-08-16 Completed Date: 1999-08-16 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7503752 Medline TA: Br J Obstet Gynaecol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 318-23 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, St. George's Hospital, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anal Canal / injuries*, surgery*, ultrasonography Delivery, Obstetric / adverse effects* Digestive System Surgical Procedures / methods Endosonography Feasibility Studies Fecal Incontinence / etiology, surgery* Female Follow-Up Studies Humans Pregnancy Rupture / surgery, ultrasonography |
| Comments/Corrections | |
Comment In:
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Br J Obstet Gynaecol. 1999 Oct;106(10):1107
[PMID:
10519442
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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