[Uncomplicated obstetric injury as a risk factor for anal incontinence? Objective assessment of manometric measurements].
The proximity of the anorectal sphincter apparatus and the vagina is a risk factor for faecal incontinence in women. To study the impact of the first delivery on anorectal continence, we evaluated 74 primiparae (41 women with midline episiotomy and 33 women with either intact perineum or Grade I tear only) and compared them to a control group of 18 nulliparous women. All subjects were examined by anorectal manometry and asked to complete a standardized questionnaire. Fourteen women of the primiparae group (eight patients with episiotomy, six pats. with intact perineum) had experienced incontinence of flatus, and 6 patients (8%, one pat. (3%) with intact perineum) had occasional incontinence of liquid or solid stool in the first weeks following delivery. We detected amongst those women who underwent episiotomy a significantly decreased maximum squeeze pressure and in women with an intact perineum a significantly decreased resting anal pressure. In all primiparae the anal canal length was significantly less when compared with control group. Even when the anal sphincter appears intact, the trauma of delivery causes detectable changes in the results of anorectal manometry, indicating a need for evaluation of the continence status at postpartum examination.
Franz
H B
HB
Institut für Medizinische Biometrie, Klinikum der Eberhard-Karls-Universität Tübingen.
Schneider
D
D
Benda
N
N
Erz
W
W
Neuer
A
A
Gonser
M
M
D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D004841:Episiotomy; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008365:Manometry; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000209:etiology*; D011247:Pregnancy; D012016:Reference Values; D012307:Risk Factors
Die unkomplizierte Geburtsverletzung als Risikofaktor analer Inkontinenz? Objektivierung durch manometrische Messungen.