Location of obstetric anal sphincter injury scars on translabial tomographic ultrasound

ABSTRACT Objective Obstetric anal sphincter injury (OASI) is a common preventable cause of anal incontinence. Both diagnosis and primary repair of OASI are often suboptimal, partly owing to the absence of effective clinical audit. The aim of this study was to evaluate the location of scars or defect...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2021-10, Vol.58 (4), p.630-633
Main Authors: Dietz, H. P., Kreft, M., Subramaniam, N., Robledo, K.
Format: Article
Language:English
Subjects:
3D/4D ultrasound
Adult
Anal Canal - diagnostic imaging
Anal Canal - injuries
anal incontinence
anal sphincter
Anus
Cicatrix - diagnostic imaging
Cicatrix - etiology
Cicatrix - pathology
Delivery, Obstetric - adverse effects
Evaluation
exoanal ultrasound
Fecal Incontinence - diagnostic imaging
Fecal Incontinence - etiology
Fecal Incontinence - pathology
Female
Gynecology
Humans
Image quality
Injuries
Injury prevention
Medical imaging
Missing data
OASI
Obstetrics
perineal tear
Pregnancy
Repair
Retrospective Studies
Scars
Single-Blind Method
Sphincter
Tomography, X-Ray Computed - methods
translabial ultrasound
Ultrasonic imaging
Ultrasonography - methods
Ultrasound
Vagina
Vulva - diagnostic imaging
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Summary:ABSTRACT Objective Obstetric anal sphincter injury (OASI) is a common preventable cause of anal incontinence. Both diagnosis and primary repair of OASI are often suboptimal, partly owing to the absence of effective clinical audit. The aim of this study was to evaluate the location of scars or defects of the external anal sphincter (EAS), diagnosed by translabial ultrasound (TLUS), following primary OASI repair. Methods This was a retrospective analysis of 309 women who were seen at a tertiary obstetric unit after primary repair of OASI between June 2012 and May 2019. All women underwent a standardized interview, including St Mark's incontinence score, followed by clinical examination and TLUS assessment within 2–9 months after OASI repair. Postprocessing of TLUS volume datasets was performed by an investigator who was blinded to all other information. Tomographic ultrasound imaging was used to evaluate the presence of a scar or defect in the proximal and distal parts of the EAS. Women were classified into four groups according to the imaging findings: (1) no visible defect or distortion (likely false positive); (2) only proximal OASI; (3) only distal OASI; and (4) both proximal and distal OASI. Results Of the 309 women seen during the study period, 34 were excluded because they were referred for reasons other than recent (
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.23719