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BJOG. 2008 Jan;115(2):234-8. Epub 2007 Nov 12.

Long-term effects of anal sphincter rupture during vaginal delivery: faecal incontinence and sexual complaints.

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  • 1Department of Gynaecology and Obstetrics, Ikazia Hospital, Rotterdam, The Netherlands. mariekemous@hotmail.com

Abstract

OBJECTIVE:

To determine the long-term effects of obstetric anal sphincter rupture on the frequency of faecal incontinence and sexual complaints.

DESIGN:

Retrospective case-control study.

SETTING:

Department of Gynaecology and Obstetrics, Ikazia Hospital, The Netherlands.

POPULATION:

All 171 women operated for anal sphincter rupture between 1971 and 1990 and 171 controls matched for parity and date of delivery.

METHODS:

Postal questionnaires regarding faecal incontinence were sent in 1996 and 2005 to all cases and controls with questions regarding sexual complaints added to the questionnaire in 2005.

MAIN OUTCOME MEASURES:

Anorectal complaints defined as any form of faecal incontinence including faecal urgency and faecal soiling. Sexual complaints defined as dyspareunia or faecal incontinence during intercourse.

RESULTS:

Sixty-one percent of the women responded to both questionnaires. Anorectal complaints were reported by 38% of case versus 16% of controls in 1996 (risk difference: 0.22, 95% CI 0.10-0.34) and by 61% of cases versus 22% of controls in 2005 (risk difference: 0.41, 95% CI 0.29-0.53). In contrast to the control group, the increase of anorectal complaints in the case group between 1996 and 2005 was highly significant (P < 0.0001). Postmenopausal state was not associated with an increased risk for faecal incontinence. Dyspareunia was reported by 29% of cases versus 13% of controls (P = 0.01). Faecal incontinence during intercourse was reported by 13% of cases versus 1% of controls (P = 0.005).

CONCLUSIONS:

Obstetric anal sphincter rupture is an important risk factor for sexual complaints and for faecal incontinence increasing with age irrespective of menopausal state.

[PubMed - indexed for MEDLINE]
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