title: Secondary repair of severe chronic fourth-degree perineal tear due to obstetric trauma.
abstract: Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the underlying complexity of obstetric injury. As prevention is not always possible, immediate recognition and adequate primary treatment is of importance.
authors.affiliation: Clinical Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon elroypat@yahoo.co.uk.
authors.forename: Elroy P
authors.initials: EP
authors.lastname: Weledji
authors.affiliation: Obstetrics, Faculty of Health Sciences, University of Buea, Cameroon.
authors.forename: Adolphe
authors.initials: A
authors.lastname: Elong
authors.affiliation: Anaesthesia and Critical Care, Faculty of Health Sciences, University of Buea, Cameroon.
authors.forename: Vincent
authors.initials: V
authors.lastname: Verla