title: [Delivery, and anal incontinence later in life].
abstract: OBJECTIVE
  Evaluation of the mutual relationship between delivery and late anal incontinence.
  
  
  METHODS
  Review.
  
  
  METHODS
  Department of Gynaecology and Obstetrics, Charles University and University Hospital Pilsen.
  
  
  CONCLUSIONS
  Anal incontinence is a symptom often referred to by women between the ages of 40 and 60. However, it seems, that only a small number of such cases might be related to obstetric perineal trauma. According to recent data, elective Caesarean section only plays a small protective role. Its effect is restricted to the first few years after delivery. With time, the function of the anal sphincter gradually deteriorates. Subsequent deliveries might contribute to this functional impairment. The long-term effect of forceps delivery is still not clear. The extent of anal sphincter trauma (particularly the defect of the internal anal sphincter) seems to have an impact on the development of anal incontinence, even years after the event. Overlooking defects of the anal sphincter is a cause of problems long after delivery. Given the unsatisfactory results of secondary overlapping, and also, relatively good preliminary effect of primary repair, careful observence of the recommended steps leading to the correct diagnostics of obstetric perineal trauma is crucial, as is adequate repair.
authors.affiliation: Gynekologicko-porodnická klinika LF UK a FN, Plzen. jstepanjr@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Stepán
authors.forename: J
authors.initials: J
authors.lastname: Karbanová
authors.forename: V
authors.initials: V
authors.lastname: Kalis
authors.forename: P
authors.initials: P
authors.lastname: Chaloupka
authors.forename: J
authors.initials: J
authors.lastname: Landsmanová
authors.forename: J
authors.initials: J
authors.lastname: Nosek
authors.forename: Z
authors.initials: Z
authors.lastname: Bukacová
authors.forename: Z
authors.initials: Z
authors.lastname: Rokyta
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000503:physiopathology; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D007744:Obstetric Labor Complications; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy