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Obstetrics anal sphincter injury and repair technique: A review
Author(s) -
Temtanakitpaisan Teerayut,
Bunyacejchevin Suvit,
Koyama Masayasu
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12630
Subject(s) - urogynecology , medicine , anal sphincter , episiotomy , obstetrics and gynaecology , childbirth , obstetrics , gynecology , sphincter , general surgery , pregnancy , surgery , urinary incontinence , biology , genetics
Abstract The U rogynecology C ommittee of the A sia and O ceania Federation of Obstetrics and Gynaecology ( AOFOG ) has held seminars and workshops on various urogynecological problems in each country in the A sia– O ceania area in order to encourage young obstetricians and gynecologists. In 2013, we organized the operative seminar for obstetrical anal sphincter injuries ( OASIS ) in which we prepared porcine models to educate young physicians in a hands‐on workshop at the 23rd A sian and O ceanic Congress of Obstetrics and Gynaecology in B angkok, T hailand. Laceration of the anal sphincter mostly occurs during vaginal delivery and it can develop into anal sphincter deficiency, which causes fecal incontinence, if an appropriate suture is not performed. OASIS has become an important issue, especially in developing countries. The prevalence of OASIS of more than the third degree is around 5% in primary parous women and the frequency is higher when detected by ultrasonographic evaluation. Several risk factors, such as macrosomia, instrumental labor, perineal episiotomy and high maternal age, have been recognized. In a society where pregnant women are getting older, OASIS is becoming a more serious issue. An intrapartum primary appropriate stitch is important, but the 1‐year outcome of a delayed operation after 2 weeks postpartum is similar. A randomized controlled study showed that overlapping suture of the external sphincter is better than that of end‐to‐end surgical repair. The U rogynecology C ommittee of the AOFOG would like to continue with educative programs about the appropriate therapy for OASIS .