title: Outcomes and follow-up after obstetric anal sphincter injuries.
abstract: OBJECTIVE
  To determine if the classification of obstetric anal sphincter injuries (OASIs) affected clinical and functional outcome and to assess the need for follow-up of 3a tears in secondary care
  
  
  METHODS
  Prospective data collection in 255 patients who sustained OASIs during repair with follow-up in a specialist clinic after 6 months.
  
  
  RESULTS
  One hundred and thirty-two patients (51.7 %) sustained 3a tears, 81 (31.7 %) 3b tears, 27 (10.6 %) 3c tears and 15 (5.8 %) had 4th degree tears. Twenty-three patients (9 %) reported symptoms at 6-month follow-up. Eight patients reported anal incontinence of liquid or solid stool. Among patients who sustained 3a tears, 8 patients were symptomatic: 7 had urgency and 1 had flatus incontinence. None of the patients who sustained 3a tears reported incontinence of solid/liquid stool. There appears to be no correlation with scan findings and symptoms at follow up. Most patients are asymptomatic. Urgency of faeces is the commonest symptom.
  
  
  CONCLUSIONS
  The vast majority of patients are asymptomatic. The necessity of seeing all these patients in secondary care for follow-up needs to be questioned. With effective primary care follow-up, there may be a place to follow up patients with 3a tears in the community during the routine 6-week postnatal check and refer the symptomatic patients to the hospital for further review.
authors: Kingston Hospital NHS trust, Galsworthy Road, Kingston, Surrey, KT2 7QB, UK. kalaivani5@yahoo.com
authors: K
authors: K
authors: Ramalingam
authors: A K
authors: AK
authors: Monga
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D003107:Colorectal Surgery; D005242:Fecal Incontinence / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007744:Obstetric Labor Complications; D011247:Pregnancy; D012189:Retrospective Studies; D063127:Secondary Health Care; D016896:Treatment Outcome