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International Urogynecology Journal

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01-09-2021 | Ultrasound | Original Article

Can ultrasound 10 days after obstetric anal sphincter injury predict anal incontinence at long-term follow-up?

Authors: Malou Barbosa, Peter Christensen, Karl Møller-Bek, Lise Brogaard, Marianne Glavind-Kristensen

Published in: International Urogynecology Journal | Issue 9/2021

Abstract

Introduction and hypothesis

The objective was to investigate whether endoanal ultrasound (EAUS) performed 10 days after a primary repaired obstetric anal sphincter injury (OASIS) can predict the severity of anal incontinence (AI) in the long term.

Methods

This prospective cohort study included women with a primary repaired 3b-degree tear, 3c-degree tear or fourth-degree tear at Aarhus University Hospital, Denmark, from 1 September 2010 to 31 May 2011. Clinical assessment and EAUS were performed on day 2, day 10, and day 20 after delivery. Functional outcomes were assessed using a questionnaire at the time of all clinical visits and at the long-term follow-up, 7 years after delivery. AI was graded according to the Wexner score and EAUS defects were graded according to the Starck score.

Results

Ninety-six out of 99 women consented to participate. Five women had a secondary sphincter repair and were subsequently excluded from follow-up. Fifty-seven women underwent both EAUS 10 days after delivery and answered the long-term follow-up questionnaire. Median follow-up time was 7.7 years (IQR 7.4–7.8). Mean Wexner score was 4.4 ± 4.8 10 days after delivery and 2.5 ± 2.8 at follow-up; thus, the Wexner score improved over time (p = 0.01). Ultrasound sphincter defects were found in 82.6% of the women. Mean Starck score was 3.0 ± 1.8. The risk of AI was 0% (95% CI 0.0–30.8) if the Starck score was 0. No correlation was found between the Starck score and the Wexner score at follow-up.

Conclusions

We found that performing EAUS in the puerperium following OASIS has limited value in predicting long-term AI.

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Title: Can ultrasound 10 days after obstetric anal sphincter injury predict anal incontinence at long-term follow-up?
Authors: Malou Barbosa
Peter Christensen
Karl Møller-Bek
Lise Brogaard
Marianne Glavind-Kristensen
Publication date: 01-09-2021
Publisher: Springer International Publishing
Keywords: Ultrasound
Ultrasound
Published in: International Urogynecology Journal / Issue 9/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04733-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Can ultrasound 10 days after obstetric anal sphincter injury predict anal incontinence at long-term follow-up?

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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