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- W2007395912 abstract "Abstract Obstetric anal incontinence is a debilitating problem affecting many women and is largely under reported. Most of this is related to direct trauma to anal sphincter during childbirth. Management of these injuries require knowledge of anal sphincter anatomy and proper classification of the injuries. Tears to the internal sphincter should be identified and repaired separately. The external anal sphincter (EAS) can be repaired either by the end-to-end or overlap technique; further prospective randomised trials are underway to determine which technique is advantageous. Antibiotics and stool softeners should be prescribed. Women should be followed up 6–8 weeks post partum by an experienced obstetrician and a careful history of bowel, urinary and sexual function taken. Anal endosonography and manometry are useful in counselling women wishing to have more children. Women with symptoms of mild anal incontinence related to anal sphincter injury should be offered a caesarean section. It remains to be established whether women who are awaiting anal sphincter repair and have not completed their family should be allowed a vaginal delivery. However, adequate counselling is mandatory as caesarean section is associated with significantly higher morbidity and mortality." @default.
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- W2007395912 date "2003-12-01" @default.
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- W2007395912 title "Management of third and fourth degree tears" @default.
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- W2007395912 doi "https://doi.org/10.1016/j.rigp.2003.08.003" @default.
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