Document Detail


Primary repair of obstetric anal sphincter rupture using the overlap technique.
MedLine Citation:
PMID:  10426237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A H Sultan; A K Monga; D Kumar; S L Stanton
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  106     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-08-16     Completed Date:  1999-08-16     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  318-23     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, St. George's Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
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:
Br J Obstet Gynaecol. 1999 Oct;106(10):1107   [PMID:  10519442 ]

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


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