Obstetric sphincter tears and XXXX : an observational follow-up study.

@entity1 @entity16 @entity322 @entity130
BACKGROUND: Persistent defects after primary sphincter repair and occult sphincter tears are common after vaginal deliveries. @entity322 may be associated with these morphological defects. MATERIAL AND METHODS: Forty-six primiparous @entity1 were evaluated with ultrasonography, manometry and electrophysiology. Twenty-four @entity1 had undergone primary repair of obstetric sphincter tears (sphincter group), 16 @entity1 had no clinical sphincter tear but developed @entity322 postpartum (symptom group), and six were delivered by elective cesarean section (cesarean group). RESULTS: In the sphincter group, 50% had @entity322 at follow-up. At ultrasonography, 70% had @entity130 anteriorly in the midanal canal. At manometry, 4% had decreased resting pressure and 50% decreased squeeze pressure. At electrophysiology, 19% had pathologic pudendal latency and 25% pathologic fiber density. In the symptom group, 44% had @entity130 anteriorly in the midanal canal at ultrasonography. At manometry, all @entity1 had normal resting pressure and 19% had a decreased squeeze pressure. At electrophysiology, 46% had pathologic pudendal latency and 29% pathologic fiber density. In the cesarean group, 33% had mild @entity322 at follow-up. Ultrasonography and manometry were normal in all @entity1 . At electrophysiology, 33% had pathologic pudendal latency and 17% pathologic fiber density. CONCLUSION: Anal sphincter @entity130 at childbirth are often inadequately diagnosed and primary repair frequently results in persisting defects in the anal sphincter. Anatomic @entity130 to the anal sphincter play an important role in the development of @entity322 after delivery, but a significant proportion of symptomatic @entity1 also demonstrate @entity16 at electrophysiologic testing.
