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Anal function following third degree tears
Author(s) -
Mackenzie N.,
Parry L.,
Tasker M.,
Gowland M. R.,
Michie H. R.,
Hobbiss J. H.
Publication year - 2004
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2004.00568.x
Subject(s) - medicine , anal sphincter , tears , sphincter , incidence (geometry) , endoanal ultrasound , internal anal sphincter , abnormality , anal verge , surgery , fecal incontinence , anal canal , rectum , physics , colorectal cancer , cancer , psychiatry , optics
Objective To assess the anal function of women who have suffered a third degree perineal tear during parturition. Patients Fifty‐three consecutive women who sustained a third degree tear, between January 1998 and March 2000, at the Princess Anne Maternity Unit, Royal Bolton Hospital were assessed. Methods Women were assessed at 3 months post partum using the Cleveland Clinic Incontinence Score, digital assessment of anal sphincter and endo‐anal ultrasound scan. Results At 3 months post partum 75% of the participants had no symptoms of anal incontinence, 18% had mild symptoms and 7% had more severe symptoms. Anal endosonography demonstrated normal anal sphincters in 66% of participants, an abnormality in the external sphincter in 29% and a defect in both sphincters in 2%. There was poor correlation between symptoms and scan defects. Conclusion The incidence of anal incontinence following repair of a third degree tear was not high and it is unlikely that we are missing a hidden pool of symptomatic women. No major change in management policy is required. The routine assessment of anal function in women who had sustained a third degree tear was appreciated by the women and enabled us to identify the small portion of women with significant symptoms.