title: The first 18 months of a new perineal trauma clinic.
abstract: Anal incontinence after childbirth is both distressing and disabling. A perineal trauma clinic was set up at the Birmingham Women's Hospital with an obstetrician, a urogynaecologist and a colorectal surgeon to improve the follow-up of women with obstetric anal sphincter injury or childbirth-precipitated anal incontinence. Fifty-five women attended the clinic. Forty-one had sustained a recognised obstetric anal sphincter injury at delivery and of these women, 61% were symptomatic with 22% leaking solid or liquid faeces. Fourteen women attended with anal incontinence who had not been recognised as sustaining an anal sphincter injury at the time of delivery. Eleven women were offered a secondary surgical repair of their anal sphincter defect. Seven accepted surgical treatment and 85% (six) were continent following surgery. A perineal trauma clinic offers an opportunity for early assessment and reduction of morbidity from childbirth-related anal incontinence.
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Birmingham Women's Hospital Edgbaston, Birmingham, UK. s.pretlove@bham.ac.uk
authors.forename: Samantha
authors.initials: S
authors.lastname: Pretlove
authors.forename: P J
authors.initials: PJ
authors.lastname: Thompson
authors.forename: P M
authors.initials: PM
authors.lastname: Toozs-Hobson
authors.forename: S
authors.initials: S
authors.lastname: Radley
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries / Q000601:surgery; D004739:England / Q000453:epidemiology; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005260:Female; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008427:Maternal Health Services / Q000592:standards* / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology; D017063:Outcome Assessment, Health Care; D010502:Perineum / Q000293:injuries* / Q000601:surgery; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery