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International Urogynecology Journal

Published in:

01-09-2009 | Original Article

Natural progression of anal incontinence after childbirth

Authors: Johan Nordenstam, Daniel Altman, Sophia Brismar, Jan Zetterström

Published in: International Urogynecology Journal | Issue 9/2009

Abstract

Introduction and hypothesis

The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.

Methods

A prospective cohort study of 304 primiparous women with singleton, cephalic delivery giving vaginal childbirth in 1995. Questionnaires distributed and collected at delivery, 9 months, 5 years and 10 years after, assessing anorectal symptoms, subsequent treatment, and obstetrical events.

Results

Women, 246 of 304, answered all questionnaires (81%). Thirty-five of 246 (14%) had a sphincter tear at the first delivery. One hundred ninety-six of 246 (80%) women had additional vaginal deliveries and no caesarean sections. The prevalence of AI at 10 years after the first delivery was 57% in women with a sphincter tear and 28% in women, a nonsignificant increase compared to the 5-year follow-up. Women who sustained a sphincter tear at the first delivery had an increased risk of severe AI (RR 3.9, 95% CI 1.3–11.8). Neither age, nor subsequent deliveries added to the risk. Severe AI at baseline and 5 years after delivery were independently strong predictors of severe AI at 10 years (RR 12.6, CI 3.3–48.3, and RR 8.3, CI 3.9–17.8, respectively).

Conclusion

Persistent anal incontinence 10 years after the first parturition is frequent and sometimes severe, especially if vaginal delivery was complicated by an anal sphincter disruption.

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Title: Natural progression of anal incontinence after childbirth
Authors: Johan Nordenstam
Daniel Altman
Sophia Brismar
Jan Zetterström
Publication date: 01-09-2009
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 9/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-0901-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Natural progression of anal incontinence after childbirth

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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