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Erschienen in: International Urogynecology Journal 11/2020

07.02.2020 | Original Article

Parturition mode recommendation and symptoms of pelvic floor disorders after obstetric anal sphincter injuries

verfasst von: Matthieu van der Vlist, Daniella Oom, Joost van Rosmalen, Astrid van Ovost, Cornelis Hogewoning

Erschienen in: International Urogynecology Journal | Ausgabe 11/2020

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Abstract

Introduction and hypothesis

Our primary objective was to evaluate parturition mode (PM) recommendations following obstetric anal sphincter injuries (OASIs) and adherence to these recommendations and to evaluate recurrence of OASIs in women who had a subsequent vaginal delivery (VD). The hypothesis was that adherence to the PM recommendations leads to a reasonable OASI recurrence rate.

Methods

This was a retrospective observational cohort study of patients with previous OASIs between 2010 and 2016. After an outpatient visit including 3D transperineal ultrasound to screen for pelvic floor and anal sphincter injuries, all patients received recommendations for a subsequent PM. Patients were invited to complete validated questionnaires 2 to 5 years post-OASIs.

Results

The majority of invited patients (265/320) attended follow-up, with 264 receiving a recommendation for PM. Only 5.6% did not adhere to the received recommendation. One hundred sixty-one patients delivered again, 58% had a VD, and 42% had a cesarean section (CS). Recurrence of OASIs was observed in 4.3% of the patients that had a VD. Fecal incontinence occurred in 4.9%, however any form of anal incontinence in 48% of patients. While dyspareunia was common in patients with residual external anal sphincter (EAS) injuries and levator ani muscle (LAM) avulsions, anal pain occurred more frequently in EAS injuries and fecal incontinence in LAM avulsions.

Conclusions

This study showed that the vast majority of patients followed PM recommendations, and this resulted in a low recurrence of OASIs with a high CS rate. Fecal incontinence after OASIs was correlated with the degree of OASIs.
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Metadaten
Titel
Parturition mode recommendation and symptoms of pelvic floor disorders after obstetric anal sphincter injuries
verfasst von
Matthieu van der Vlist
Daniella Oom
Joost van Rosmalen
Astrid van Ovost
Cornelis Hogewoning
Publikationsdatum
07.02.2020
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 11/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-020-04241-4

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