Introduction And Hypothesis: The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.
Methods: A prospective cohort study of 304 primiparous women with singleton, cephalic delivery giving vaginal childbirth in 1995. Questionnaires distributed and collected at delivery, 9 months, 5 years and 10 years after, assessing anorectal symptoms, subsequent treatment, and obstetrical events.
Results: Women, 246 of 304, answered all questionnaires (81%). Thirty-five of 246 (14%) had a sphincter tear at the first delivery. One hundred ninety-six of 246 (80%) women had additional vaginal deliveries and no caesarean sections. The prevalence of AI at 10 years after the first delivery was 57% in women with a sphincter tear and 28% in women, a nonsignificant increase compared to the 5-year follow-up. Women who sustained a sphincter tear at the first delivery had an increased risk of severe AI (RR 3.9, 95% CI 1.3-11.8). Neither age, nor subsequent deliveries added to the risk. Severe AI at baseline and 5 years after delivery were independently strong predictors of severe AI at 10 years (RR 12.6, CI 3.3-48.3, and RR 8.3, CI 3.9-17.8, respectively).
Conclusion: Persistent anal incontinence 10 years after the first parturition is frequent and sometimes severe, especially if vaginal delivery was complicated by an anal sphincter disruption.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00192-009-0901-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience.
Arch Gynecol Obstet
January 2025
Clinic of Obstetrics and Gynecology, "S. Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
Purpose: The objective of this study is to evaluate the impact of pelvic floor physical therapy (PFPT) on symptoms and quality of life in women who experienced third- and fourth-degree perineal tears (Obstetric Anal Sphincter Injuries, OASIS) during childbirth. OASIS can lead to anal incontinence and dyspareunia, having important implications regarding the quality of life and health of women but, unfortunately, there is no standard practice for postpartum care following OASIS.
Methods: In this retrospective observational study, patients diagnosed with OASIS between January 2016 and June 2023 were enrolled.
The Clinical Utility of Anorectal Manometry: A Review of Current Practices.
Gastro Hep Adv
October 2024
Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Anorectal manometry (ARM) is a diagnostic test that utilizes pressure sensors to dynamically measure intraluminal anal and rectal pressures, thus providing an objective evaluation of anorectal functional parameters (tone, contractility, and relaxation), coordination and reflex activity, and sensation. ARM is a useful test for numerous indications including for the assessment and management of functional anorectal disorders such as fecal incontinence, functional defecatory disorders, and functional anorectal pain, preoperative assessment of anorectal function, and in facilitating/assessing response to biofeedback training. In addition, while many functional anorectal disorders present with overlapping symptoms (ie constipation, anorectal pain), ARM allows delineation of more specific disease processes and may guide treatment more effectively.
View Article and Find Full Text PDFAnd after surgery, what's new for the rectal cancer survivor?
Cir Esp (Engl Ed)
January 2025
Unidad de Cirugía Colorrectal, Servicio de Cirugía General y Digestiva, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Low anterior resection syndrome is a common but underestimated complication after rectal cancer surgery that significantly impacts the quality of life of the surviving patient. It is characterized by symptoms such as fecal incontinence and voiding dysfunction and affects up to 90% of patients undergoing low anterior rectal resection. The etiology of the syndrome is multifactorial with no clear determining factor.
View Article and Find Full Text PDFThe prevalence of incontinence after excisional hemorrhoidectomy and stapled hemorrhoidopexy: A systematic review and meta-analysis.
Surgery
January 2025
South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
Background: Excisional hemorrhoidectomy and stapled hemorrhoidopexy are 2 common procedures for treating symptomatic hemorrhoids. However, concerns persist regarding the risk of postoperative complications and their unclear prevalence in the literature. This systematic review aims to evaluate and compare the prevalence of incontinence after stapled hemorrhoidopexy and excisional hemorrhoidectomy.
View Article and Find Full Text PDFThe Songdo consensus: Development of minimum reporting standards for studies of intervention in idiopathic anal fistula using a modified nominal group technique.
Colorectal Dis
January 2025
Robin Phillips' Fistula Research Unit, St Mark's Hospital, London, UK.
Aim: Cryptoglandular anal fistulas carry a substantial burden to quality of life. Surgery is the only effective curative treatment but requires balancing fistula healing against pain, wounds and continence impairment. Sphincter-preserving procedures do exist but demonstrate variable rates of success.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!