title: Long-term outcome of obstetric anal sphincter injury repaired by experienced obstetricians.
abstract: OBJECTIVE
  To examine the long-term outcomes of women with obstetric anal sphincter injury (OASI) repaired by obstetricians without the involvement of colorectal surgeons.
  
  
  METHODS
  A retrospective cohort study was undertaken of women who had been admitted for delivery between 2004 and 2012. All OASIs had been repaired by experienced obstetricians using the end-to-end technique. An unexposed group (no OASI) was matched at a ratio of 1:1. Fecal incontinence was graded using a modified Wexner questionnaire.
  
  
  RESULTS
  Overall, 113 OASIs were recorded. Sixty-seven (59.3%) and 71 (62.8%) women from the exposed and unexposed groups, respectively, agreed to participate in the study (P=0.9). Continence to both stool and gas was reported by 48 (71.6%) and 64 (90.1%) women in the exposed and unexposed groups, respectively (P=0.03). The incidence of urgency, dyspareunia, and use of a pad or constipating agents was the same in both groups.
  
  
  CONCLUSIONS
  The long-term outcome of OASI repair performed by experienced obstetricians is comparable to that reported in the literature. Some women who did not sustain an OASI reported fecal incontinence, which suggests that only a proportion of fecal incontinence can be attributed to OASI.
authors.affiliation: Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Technion, Rappaport Faculty of Medicine, Haifa, Israel. Electronic address: salim_ra@clalit.org.il.
authors.forename: Raed
authors.initials: R
authors.lastname: Salim
authors.affiliation: Technion, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Hadar
authors.initials: H
authors.lastname: Peretz
authors.affiliation: Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Urogynecological Unit, Emek Medical Center, Afula, Israel.
authors.forename: Robert
authors.initials: R
authors.lastname: Molnar
authors.affiliation: Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Urogynecological Unit, Emek Medical Center, Afula, Israel.
authors.forename: Meirav
authors.initials: M
authors.lastname: Braverman
authors.affiliation: Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
authors.forename: Aliza
authors.initials: A
authors.lastname: Hatokay
authors.affiliation: Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Technion, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Eliezer
authors.initials: E
authors.lastname: Shalev
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries* / Q000601:surgery; D004414:Dyspareunia / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007744:Obstetric Labor Complications / Q000601:surgery*; D009774:Obstetrics; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Experienced obstetricians; Fecal incontinence; Long-term outcome; Obstetric anal sphincter injury