OBJECTIVE To assess the association of oxytocin augmentation with obstetric anal sphincter injury among nulliparous women. DESIGN Population-based, case-control study. SETTING Primary and secondary teaching hospital serving a Norwegian region. POPULATION 15 476 nulliparous women with spontaneous start of labour, single cephalic presentation and gestation ≥37 weeks delivering vaginally bet...

The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal d...

Anal sphincter injury during childbirth is a leading cause of anal incontinence. In a study of more than 20 000 consecutive vaginal deliveries, clinically diagnosed obstetric anal sphincter injury occurred in 2.9% of primiparous women and 0.8% of multiparous ones. Of women who have sustained such an injury, 60-80% are asymptomatic at 12 months, of whom most report incontinence of flatus only, r...

BACKGROUND There is still considerable debate about the value of preoperative anorectal physiological parameters in predicting the clinical outcome after sphincteroplasty. Recently it has been reported that atrophy of the external anal sphincter can be clearly shown with endoanal magnetic resonance imaging (MRI). The aims of this study were to investigate the prevalence of external anal sphinct...

PURPOSE Transanal stapled anastomosis has been associated with continence disturbances and reduced postoperative anal sphincter function. The aim of the present work was to study the effect of transanal stapling on anal sphincter morphology by endoanal ultrasound. METHODS Thirty-nine consecutive patients undergoing stapled low anterior resection for rectal carcinoma were assessed. Each patien...

The aim of this study was to assess the prevalence and risk factors of anal incontinence in an unselected pregnant population at second trimester. A survey of pregnant women attending a routine ultrasound examination was conducted in a university hospital in Oslo, Norway. A questionnaire consisting of 105 items concerning anal incontinence (including St. Mark's score), urinary incontinence, med...

AIM Structural anal sphincter damage may be secondary to obstetric anal sphincter injury, perineal trauma or anorectal surgery. We reviewed the spectrum of anal sphincter injuries and their outcomes in a tertiary care colorectal unit. METHODS Data of patients who underwent anal sphincter repair between 2004 and 2008 were analyzed retrospectively. Outcomes were compared with respect to etiolog...

...................................................................................................................9 INTRODUCTION ......................................................................................................11 REVIEW OF THE LITERATURE .............................................................................13 1. History of anal incontinence ............................

Obstetric anal sphincter injury is the leading cause of faecal incontinence in women. Concerns have been expressed that some sphincter injuries are missed at the time of vaginal childbirth. There has also been a steady increase in the number of medico-legal cases associated with obstetric sphincter injury. Accurate diagnosis of third and fourth degree tears at the time of childbirth followed by...