Avoiding obstetrical injury to the anal sphincter is the single biggest factor in preventing anal incontinence among women. Any form of instrument delivery has consistently been noted to increase the risk of obstetric anal sphincter injury and altered fecal continence by between 2- and 7-fold. Routine episiotomy is not recommended. Episiotomy use should be restricted to situations where it dire...

PURPOSE: To evaluate the prevalence of anal incontinence (AI) in primiparous women five years after their first delivery; to investigate if an 8-12 hour time delay of primary repair affects AI at 1-year follow-up; to study the association between endoanal ultrasonography and anorectal manometry in relation to AI in primiparous women; to evaluate whether an endoanal ultrasonographic derived sphi...

BACKGROUND Perception of, and adaptation of the rectum to, distension probably play an important role in the maintenance of continence, but perception studies in faecal incontinence provide controversial conclusions possibly related to methodological biases. In order to better understand perception disorders, the aim of this study was to analyse anorectal adaptation to rectal isobaric distensio...

BACKGROUND Incontinence of stool and flatus are frequent complications of childbirth. We examined the prevalence and possible causes of these adverse outcomes in a large cohort of women. METHODS We studied 949 pregnant women who gave birth in 5 hospitals in 1995/96 in the province of Quebec. These women, participants in a randomized controlled trial of prenatal perineal massage, completed a s...

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...

OBJECTIVE To compare the pelvic floor function of primiparous women to women after a second delivery regarding symptoms of urinary and anal incontinence, anal sphincter ruptures and bladder-neck mobility. METHODS A questionnaire evaluating symptoms of urinary and anal incontinence was used in nulliparous women before and 27 months after childbirth. Furthermore these symptoms were correlated w...

BACKGROUND Long-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence. METHODS In a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sp...

Changes of denervation in the anal sphincter striated and smooth muscle in patients with neurogenic faecal incontinence are well established. This study aimed to determine if there is also a more proximal visceral autonomic abnormality. Thirty women with purely neurogenic faecal incontinence (prolonged pudendal nerve latencies and an intact sphincter ring) and 12 patients with neuropathic chang...