Residual defects after repair of obstetric anal sphincter injuries and pelvic floor muscle strength are related to anal incontinence symptoms

Introduction and hypothesis The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). Methods From September 2012 to February 2015, an observational...

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Bibliographic Details
Published in:International Urogynecology Journal 2017-03, Vol.28 (3), p.455-460
Main Authors: Cerro, Cristina Ros, Franco, Eva Martínez, Santoro, Giulio Aniello, Palau, Maria José, Wieczorek, Pawel, Espuña-Pons, Montserrat
Format: Article
Language:English
Subjects:
Adult
Anal Canal - injuries
Delivery, Obstetric - adverse effects
Fecal Incontinence - etiology
Female
Gynecology
Humans
Lacerations - classification
Lacerations - etiology
Lacerations - surgery
Medicine
Medicine & Public Health
Muscle Strength - physiology
Obstetric Labor Complications - etiology
Original Article
Pelvic Floor
Pregnancy
Regression Analysis
Treatment Outcome
Urology
Wound Healing - physiology
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Summary:Introduction and hypothesis The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). Methods From September 2012 to February 2015, an observational study was conducted on a cohort of females who underwent repair of OASIS intrapartum. The degree of OASIS was scored intrapartum according to Sultan’s classification. Participants were assessed at 6 months postpartum. Incontinence symptoms were evaluated using Wexner’s score and PFM strength using the Modified Oxford Scale (MOS). 3D-endoanal ultrasound was performed to classify AS defects according to Starck’s system. Correlation between Sultan’s and Starck’s classifications was calculated using Cohen’s kappa and Spearman’s rho (R s ) test. The impact of residual AS defects and PFM strength on AI was analyzed using a multiple regression model. Results A total of 95 women were included in the study. Good correlation (κ= 0.72) was found between Sultan’s and Starck’s classifications. Significant positive correlation was observed between Wexner’s score and both Sultan’s ( p  = 0.023, R s =0.212) and Starck’s ( p  
ISSN:0937-3462
1433-3023
DOI:10.1007/s00192-016-3136-z