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Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears.

Publication ,  Journal Article
Richter, HE; Fielding, JR; Bradley, CS; Handa, VL; Fine, P; FitzGerald, MP; Visco, A; Wald, A; Hakim, C; Wei, JT; Weber, AM ...
Published in: Obstet Gynecol
December 2006

OBJECTIVE: To estimate whether endoanal ultrasound findings are more prevalent in primiparous women with a history of anal sphincter tear than in women without this history and whether the findings are associated with fecal incontinence symptoms. METHODS: A total of 251 primiparous women at seven clinical sites underwent standardized ultrasound assessment of the internal and external anal sphincter 6-12 months after delivery. Participants were women in the three cohorts of the Childbirth and Pelvic Symptoms Study: 1) women with clinically evident third- or fourth-degree tear at vaginal delivery (n=106); 2) no tear at vaginal delivery (n=106); and 3) cesarean delivery without labor (n=39). Women completed the Fecal Incontinence Severity Index to assess fecal incontinence symptoms. RESULTS: Thirty-five percent of the sphincter tear group exhibited internal sphincter gaps compared with 3% of vaginal controls (odds ratio [OR] 18.4, 95% confidence interval [CI] 5.5-62.1) and 10% of cesarean controls. External sphincter gaps were identified in 51% of the tear group compared with 31% of vaginal controls (OR 2.3, 95% CI 1.3-4.0) and 28% of cesarean controls. In the tear group, fecal incontinence severity was greater in those with internal sphincter gaps compared with those with no internal sphincter gaps (Fecal Incontinence Severity Index score 6.6+/-8.3 compared with 3.3+/-6.1, P=.02), as well as in those with external sphincter gaps (6.1+/-8.4 compared with 2.7+/-5.0, P=.01), and greatest in those with both internal and external sphincter gaps compared with at least one gap not present (7.2+/-8.1 compared with 3.4+/-6.4, P=.003). CONCLUSION: Anal sphincter gaps detected by ultrasonography are prevalent in postpartum primiparous women with a history of sphincter tear and are associated with fecal incontinence severity. LEVEL OF EVIDENCE: II-2.

Duke Scholars

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

December 2006

Volume

108

Issue

6

Start / End Page

1394 / 1401

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
  • Fecal Incontinence
  • Endosonography
  • Anal Canal
  • Adult
  • 3215 Reproductive medicine
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Richter, H. E., Fielding, J. R., Bradley, C. S., Handa, V. L., Fine, P., FitzGerald, M. P., … Pelvic Floor Disorders Network, . (2006). Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears. Obstet Gynecol, 108(6), 1394–1401. https://doi.org/10.1097/01.AOG.0000246799.53458.bc
Richter, Holly E., Julia R. Fielding, Catherine S. Bradley, Victoria L. Handa, Paul Fine, Mary Pat FitzGerald, Anthony Visco, et al. “Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears.Obstet Gynecol 108, no. 6 (December 2006): 1394–1401. https://doi.org/10.1097/01.AOG.0000246799.53458.bc.
Richter HE, Fielding JR, Bradley CS, Handa VL, Fine P, FitzGerald MP, et al. Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears. Obstet Gynecol. 2006 Dec;108(6):1394–401.
Richter, Holly E., et al. “Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears.Obstet Gynecol, vol. 108, no. 6, Dec. 2006, pp. 1394–401. Pubmed, doi:10.1097/01.AOG.0000246799.53458.bc.
Richter HE, Fielding JR, Bradley CS, Handa VL, Fine P, FitzGerald MP, Visco A, Wald A, Hakim C, Wei JT, Weber AM, Pelvic Floor Disorders Network. Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears. Obstet Gynecol. 2006 Dec;108(6):1394–1401.
Journal cover image

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

December 2006

Volume

108

Issue

6

Start / End Page

1394 / 1401

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
  • Fecal Incontinence
  • Endosonography
  • Anal Canal
  • Adult
  • 3215 Reproductive medicine
  • 1114 Paediatrics and Reproductive Medicine