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BMC Pregnancy Childbirth. 2010 Sep 9;10:51. doi: 10.1186/1471-2393-10-51.

A modified surgical approach to women with obstetric anal sphincter tears by separate suturing of external and internal anal sphincter. A modified approach to obstetric anal sphincter injury.

Author information

1
Departments of Obstetrics and Gynecology, Clintech, Karolinska University Hospital, Huddinge, 14186 Huddinge, Sweden. pelle.lindqvist@ki.se

Abstract

BACKGROUND:

Long-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence.

METHODS:

In a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sphincter muscles with monofilament absorbable sutures. The principal outcome assessed by answers given to six questions, was a difference in anal incontinence score, between the study group and two control groups (women with prior OASI [n = 180] and primiparous women delivered vaginally without a diagnose of OASI [n = 100]).

RESULTS:

An anal incontinence score of zero (i.e., no symptoms) was found in 74% of the study group, 47% of the OASI control group, and 66% of the vaginal control group (p = 0.02 and 0.5, as compared to the study group).

CONCLUSIONS:

A modified suturing technique was followed by significant improved one-year symptoms of anal incontinence as compared to historical cases.

PMID:
20828380
PMCID:
PMC2949785
DOI:
10.1186/1471-2393-10-51
[Indexed for MEDLINE]
Free PMC Article

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