title: Unsuspected sphincter damage following childbirth revealed by anal endosonography.
abstract: Anal endosonography was performed in 62 consecutive patients with incontinence of flatus or faeces following obstetric trauma, and in 18 parous controls. Of the incontinent group, 90% had defects in the external sphincter, 65% in the internal sphincter and 44% disruption of the perineal body, compared with none of the controls. This triad of lesions is pathognomonic of obstetric trauma. Anal endosonography revealed a higher prevalence of sphincter damage than expected from anorectal physiology tests, and therefore has a role in screening patients following complicated or difficult deliveries.
authors.affiliation: Department of Radiology, St Mark's Hospital, London, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Burnett
authors.forename: C
authors.initials: C
authors.lastname: Spence-Jones
authors.forename: C T
authors.initials: CT
authors.lastname: Speakman
authors.forename: M A
authors.initials: MA
authors.lastname: Kamm
authors.forename: C N
authors.initials: CN
authors.lastname: Hudson
authors.forename: C I
authors.initials: CI
authors.lastname: Bartram
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging*; D001004:Anus Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D036861:Delivery, Obstetric / Q000009:adverse effects; D005242:Fecal Incontinence / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008875:Middle Aged; D011247:Pregnancy; D014463:Ultrasonography