title: Obstetrical anal sphincter laceration and anal incontinence 5-10 years after childbirth.
abstract: OBJECTIVE
  The purpose of this study was to investigate the long-term impact of anal sphincter laceration on anal incontinence.
  
  
  METHODS
  Five to 10 years after first delivery, anal incontinence and other bowel symptoms were measured with the Epidemiology of Prolapse and Incontinence Questionnaire and the short form of the Colorectal-Anal Impact Questionnaire. Obstetric exposures were assessed with review of hospital records. Symptoms and quality-of-life impact were compared among 90 women with at least 1 anal sphincter laceration, 320 women who delivered vaginally without sphincter laceration, and 527 women who delivered by cesarean delivery.
  
  
  RESULTS
  Women who sustained an anal sphincter laceration were most likely to report anal incontinence (odds ratio, 2.32; 95% confidence interval, 1.27-4.26) and reported the greatest negative impact on quality of life. Anal incontinence and quality-of-life scores were similar between women who delivered by cesarean section and those who delivered vaginally without sphincter laceration.
  
  
  CONCLUSIONS
  Anal sphincter laceration is associated with anal incontinence 5-10 years after delivery.
authors: Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors: Emily C
authors: EC
authors: Evers
authors: Joan L
authors: JL
authors: Blomquist
authors: Kelly C
authors: KC
authors: McDermott
authors: Victoria L
authors: VL
authors: Handa
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D022125:Lacerations / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires