Outcome of obstetric anal sphincter injuries (OASIS)--role of structured management.
OBJECTIVE
Prospective studies up to 1 year after repair of obstetric anal sphincter injuries (OASIS) report anal incontinence in 33% of women and up to 92% have a sonographic sphincter defect. The aim of this study is to determine the outcome of repair by doctors who have undergone structured training using a standardized protocol.


METHODS
Doctors repaired OASIS after attending a training workshop. The external anal sphincter was repaired by the end-to-end technique when partially divided and the overlap method when completely divided. Endoanal ultrasound was performed prior to suturing and 7 weeks later. A validated bowel symptom questionnaire was completed prior to delivery, at 7 weeks postpartum, and at 1 year postpartum.


RESULTS
Fifty-nine women sustained OASIS. At 7 weeks, six (10%) had a defect on ultrasound. There was no significant deterioration in symptoms of fecal urgency, incontinence, or quality of life at 1 year after delivery.


CONCLUSIONS
The 1-year outcome after repair of OASIS appears to be good when repaired by doctors after structured training.
Mayday University Hospital, London Road, Croydon, Surrey CR7 7YE, UK.
Vasanth
V
Andrews
Ranee
R
Thakar
Abdul H
AH
Sultan
D001003:Anal Canal / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D019091:Critical Pathways; D036861:Delivery, Obstetric / Q000009:adverse effects; D004502:Education, Medical, Continuing; D005242:Fecal Incontinence / Q000517:prevention & control; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D010502:Perineum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011446:Prospective Studies; D013536:Suture Techniques / Q000193:education* / Q000592:standards; D014463:Ultrasonography