Fecal incontinence: a review of prevalence and obstetric risk factors.
Anal incontinence (AI) is a significant problem that causes social and hygienic inconvenience. The true prevalence of AI is difficult to estimate due to inconsistencies in research methods, but larger studies suggest a rate of 2-6% for incontinence to stool. There is a significant association between sonographically detected anal sphincter defects and symptoms of AI. The intrapartum factors most consistently associated with a higher risk of AI include: forceps delivery, third or fourth degree tears, and length of the second stage of labor. Fetal weight of > 4,000 g is also associated with AI. Repair of the sphincter can be performed in either an overlapping or an end-to-end fashion, with similar results for both methods. The role of cesarean delivery for the prevention of AI remains unclear, and further study should be devoted to this question.
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Ave, 1st Floor Suite C, Bronx, NY 10467, USA. awang@montefiore.org
Andrea
A
Wang
Marsha
M
Guess
Kathleen
K
Connell
Kenneth
K
Powers
George
G
Lazarou
Magdy
M
Mikhail
D001003:Anal Canal / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D001004:Anus Diseases / Q000209:etiology; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000295:instrumentation; D005242:Fecal Incontinence / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors