Anal function following third degree tears.
OBJECTIVE
To assess the anal function of women who have suffered a third degree perineal tear during parturition.


METHODS
Fifty-three consecutive women who sustained a third degree tear, between January 1998 and March 2000, at the Princess Anne Maternity Unit, Royal Bolton Hospital were assessed.


METHODS
Women were assessed at 3 months post partum using the Cleveland Clinic Incontinence Score, digital assessment of anal sphincter and endo-anal ultrasound scan.


RESULTS
At 3 months post partum 75% of the participants had no symptoms of anal incontinence, 18% had mild symptoms and 7% had more severe symptoms. Anal endosonography demonstrated normal anal sphincters in 66% of participants, an abnormality in the external sphincter in 29% and a defect in both sphincters in 2%. There was poor correlation between symptoms and scan defects.


CONCLUSIONS
The incidence of anal incontinence following repair of a third degree tear was not high and it is unlikely that we are missing a hidden pool of symptomatic women. No major change in management policy is required. The routine assessment of anal function in women who had sustained a third degree tear was appreciated by the women and enabled us to identify the small portion of women with significant symptoms.
Royal Bolton Hospital, Bolton, UK.
N
N
Mackenzie
L
L
Parry
M
M
Tasker
M R
MR
Gowland
H R
HR
Michie
J H
JH
Hobbiss
D001003:Anal Canal / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D001004:Anus Diseases / Q000209:etiology*; D036861:Delivery, Obstetric / Q000009:adverse effects*; D013505:Digestive System Surgical Procedures / Q000379:methods; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D020127:Recovery of Function; D016896:Treatment Outcome