Anal sphincter injury, fecal and urinary incontinence: a 34-year follow-up after forceps delivery.
OBJECTIVE
This study was designed to determine the long-term outcome of forceps delivery in terms of evidence of anal sphincter injury and the incidence of fecal and urinary incontinence.


METHODS
Women who delivered in 1964 were evaluated by using endoanal ultrasound, manometry, and a continence questionnaire. Women delivered by forceps were matched with the next normal delivery and elective cesarean delivery in the birth register.


RESULTS
The women's overall obstetric history was evaluated. Women who had ever had a forceps delivery (n = 42) had a significantly higher incidence of sphincter rupture compared with women who had only unassisted vaginal deliveries (n = 41) and elective cesarean sections (n = 6) (44 vs. 22 vs. 0 percent; chi-squared 7.09; P = 0.03). There was no significant difference in the incidence of significant fecal incontinence between the three groups (14 vs. 10 vs. 0 percent) or significant urinary incontinence (7 vs. 19 vs. 0 percent).


CONCLUSIONS
Anal sphincter injury was associated with forceps delivery in the past; however, significant fecal and urinary incontinence was not.
Bollard
Ruth C
RC
Academic Surgical Unit, University of Hull, Castle Hill Hospital, Cottingham North Humberside, United Kingdom.
Gardiner
Angela
A
Duthie
Grahame S
GS
Lindow
Stephen W
SW
D001003:Anal Canal / Q000000981:diagnostic imaging / Q000293:injuries*; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000379:methods; D005242:Fecal Incontinence / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008365:Manometry; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D009772:Obstetrical Forceps / Q000009:adverse effects*; D011247:Pregnancy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000453:epidemiology*