Introduction and aim of the study: The prevalence of obstetric anal sphincter tear in the Netherlands is approximately two percent [
[1]
]. 3D/4D transperineal ultrasound is a non-invasive imaging method which can be considered as a valuable investigation method for the detection of anal sphincter defects [[2]
].This study was designed to evaluate pelvic floor symptoms with the findings after primary sphincter repair on 3D/4D ultrasound.
Materials and methods: Two hundred and twelve women who were diagnosed with anal sphincter tear visiting a tertiary pelvic floor clinic between 2006 and 2016 were asked to fill in a standardized questionaire. Pelvic Floor Distress Inventory (PFDI) scores and St. Mark's incontinence scores were noted. All patients underwent a standardized 3D/4D pelvic floor ultrasound at least three months postpartum (Table 1).
Table 1
| Degree of sphincter tear based on ultrasound | Number of patients | Mean PFDI score | Mean St. Mark's score |
|---|---|---|---|
| 3A | 17 | 44.59 (0–159.79) | 4.88 (0–13) |
| 3B | 27 | 38.44 (0–192.92) | 4,22 (0–17) |
| 3C | 15 | 29.93 (0–95.42) | 3.13 (0–7) |
| No defect on ultrasound | 14 | 62.80 (0–111.46) | 4.39 (0–11) |
Results: Seventy-three women filled in the questionnaire.
Interpretation of results: Severity of the PFDI score and/or St. Mark's score was not associated with the severity of the anal sphincter injury.
Conclusions: Persistent complaints occur in 54.17% of the patients (St. Marks score > 4 and/or PFDI score >45)
References
- Risk factors for third degree perineal ruptures during delivery.Brit J Obstet Gynaec. 2001; 108: 383-387https://doi.org/10.1016/S0306-5456(00)00090-5
- Detection of Anal Sphincter Defects in Female Patients With Fecal Incontinence: A Comparison of 3-Dimensional Transperineal Ultrasound and 2-Dimensional Endoanal Ultrasound.Dis Colon Rectum. 2012; 55: 646-652https://doi.org/10.1097/Dcr.0b013e318251dca1
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© 2017 Published by Elsevier Inc.
