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

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

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

Holly E Richter,Julia R Fielding,Catherine S Bradley,Victoria L Handa,Paul Fine,Mary Pat FitzGerald,Anthony Visco,Arnold Wald,Christiane Hakim,J T Wei,Anne M Weber, ,

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.

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

HE Richter,JR Fielding,CS Bradley,VL Handa,P Fine,MP FitzGerald,A Visco,A Wald,C Hakim,JT Wei,AM Weber, ,

For similar animals: chordata: vertebrates: mammals: primates: haplorhini: catarrhini: hominidae: humans research abstracts see: animals: chordata: vertebrates: mammals: primates: haplorhini: catarrhini: hominidae: humans research

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

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Obstetrics and gynecology

VOLUME: 108

Page Numbers: 1394-401

Journal Abbreviation:

ISSN: 0029-7844

DAY: 3

MONTH: Dec

YEAR: 2006

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

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LANGUAGE: eng

NlmUniqueID: 401101

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

KEYWORDS: Humans

MESH TERMS: ultrasonography

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

AFFILIATION: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama 35249-7333, and Division of Radiology, Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA. hrichter@uabmc.edu

Country: United States

AGENCY: United States NICHD

GRANT: U10 HD41269

ACRONYM: HD

MEDLINETA: Obstet Gynecol

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