Results of surgical treatment of anal sphincter injury following vaginal delivery at Hanoi Medical University Hospital: a case series report

Tran Ngoc Dung, Tran Bao Long, Luu Quang Dung, Nguyen Thi Thu Vinh, Nguyen Duc Phan

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Tóm tắt

The repair of sphincter injury following vaginal delivery is often inadequate or the injury was undetected. The consequence is fecal incontinence. In this descriptive study, five patients underwent sphincter repair by the “overlap” technique. Evaluation of postoperative outcomes at 3 and 12 months showed that the Wexner fecal incontinence score at 17 - 20 score decreased to 0 - 6 score. Transperineal ultrasound showed that all five patients healed well. Measurement of anal manometry, functional anal canal length, resting anal pressures and squeezing anal pressures was better after surgery.

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Tài liệu tham khảo

1. Kapoor DS, Thakar R, Sultan AH. Obstetric anal sphincter injuries: Review of anatomical factors and modifiable second stage interventions. Int Urogynecol J Pelvic Floor Dysfunct. 2015;26(12):1725-1734.
2. Spinelli A, Laurenti V, Carrano FM, Gonzalez-Díaz E, Borycka-Kiciak K. Diagnosis and Treatment of Obstetric Anal Sphincter Injuries: New Evidence and Perspectives. J Clin Med. 2021;10(15):3261.
3. Fenner DE, Genberg B, Brahma P, Marek L, DeLancey JO. Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetric unit in the United States. Am J Obstet Gynecol. 2003;189(6):1543-1550.
4. Fernando RJ, Sultan AH, Radley S, Jones PW, Johanson RB. Management of obstetric anal sphincter injury: a systematic review and national practice survey. BMC Health Serv Res. 2002;2(1):9.
5. Rockwood TH. Incontinence severity and QOL scales for fecal incontinence. Gastroenterology. 2004;126:S106-S113.
6. Goffeng A, Andersch B, Andersson M, Berndtsson I, Hulten L, ÖResland T. Objective methods cannot predict anal incontinence after primary repair of extensive anal tears. Acta Obstet Gynecol Scand. 1998;77(4):439-443.
7. Nazir M, Carlsen E, Jacobsen AF, Nesheim BI. Is There Any Correlation Between Objective Anal Testing, Rupture Grade, and Bowel Symptoms After Primary Repair of Obstetric Anal Sphincter Rupture?. Dis Colon Rectum. 2002;45(10):1325-1331.
8. Adams EJ, Bricker L, Richmond DH, Neilson JP. Systematic review of third degree tears: Risk factors. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(Suppl. 3):12.
9. Cook TA, Keane DP, Mortensen NJ. Is there a role for the colorectal team in the management of acute severe third-degree vaginal tears?. Colorectal Disease. 1999;1(5): 263-266.
10. Le Manh Cuong, Ha Van Quyet, Tran Manh Hung, et al. Normal values for high-resolution anorectal manometry in healthy young adults: evidence from Vietnam. BMC Gastroenterol. 2021;21:295.