title: Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery.
abstract: OBJECTIVE
  This study aims to estimate fecal, urinary incontinence, and sexual function 6 years after an obstetrical anal sphincter tear.
  
  
  METHODS
  Among 13,213 women who had a vaginal delivery of a cephalic singleton at term, 196 women sustained an anal sphincter tear. They were matched to 588 controls. Validated questionnaires grading fecal and urinary incontinence, and sexual dysfunction were completed by the participants.
  
  
  RESULTS
  Severe fecal incontinence was more frequently reported by women who had sustained an anal sphincter tear compared to the controls. Women with an anal sphincter tear had no increased risk of urinary incontinence, but reported significantly more pain, difficulty with vaginal lubrication, and difficulty achieving orgasm compared to the controls. A fetal occiput posterior position during childbirth was an independent risk factor for both severe urinary incontinence and severe sexual dysfunction.
  
  
  CONCLUSIONS
  Fecal incontinence is strongly associated with an anal sphincter tear. A fetal occiput posterior position represents a risk factor for urinary incontinence and sexual dysfunction.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Lausanne, Maternity-CHUV, 1011 Lausanne, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Baud
authors.forename: Sylvain
authors.initials: S
authors.lastname: Meyer
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vial
authors.forename: Patrick
authors.initials: P
authors.lastname: Hohlfeld
authors.forename: Chahin
authors.initials: C
authors.lastname: Achtari
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries* / Q000601:surgery; D016022:Case-Control Studies; D005113:Extraction, Obstetrical / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007746:Labor Presentation; D016015:Logistic Models; D059952:Pelvic Floor Disorders / Q000209:etiology; D011247:Pregnancy; D012307:Risk Factors; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology*