Impact of residual defect of anal sphincter on patients` quality of life

Abstract

Aim

The aim of this retrospective study is to correlate the presence of residual anal sphincter defect with the quality of life of patients after vaginal delivery complicated with obstetrical anal sphincter injury.

Study group and methods

Patients diagnosed with obstetrical anal sphincter injury are dispensed in our urogynecological unit, with mean follow-up period of 37 months. Two investigators blinded to results of clinical symptoms evaluated archived ultrasound volumes for presence of residual anal sphincter defect that were later correlated with St. Mark`s Incontinence Score.

Results and conclusions

The group comprises of 181 patients diagnosed with obstetrical anal sphincter injury that underwent an ultrasound exam of anal sphincter at three months post-partum. The questionnaires were completed by 118 patients (65.2 % of all patients).

In seven cases (5.9 %) residual sphincter defect was diagnosed. In the group with residual defect, fecal urgency (lack of ability to defer defecation) was present in 57.1 %. In group of patients without residual anal sphincter defect fecal urgency was present in 12.6 %. This difference is significant (.00097) with contingency coefficient 0.291. It can be concluded that presence of residual anal sphincter defect increases the probability of fecal urgency.