Anal sphincter trauma and anal incontinence in urogynecological patients

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
R A Guzmán RojasH P Dietz

Abstract

To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma. This was a retrospective analysis of ultrasound volume datasets of 501 patients attending a tertiary urogynecological unit. All patients underwent a standardized interview including determination of St Mark's score for those presenting with AI. Tomographic ultrasound imaging (TUI) was used to evaluate the EAS and the internal anal sphincter (IAS). Among a total of 501 women, significant EAS and IAS defects were found in 88 and 59, respectively, and AI was reported by 69 (14%). Optimal prediction of AI was achieved using a model that included four abnormal slices of the EAS on TUI. IAS defects were found to be less likely to be associated with AI. In a multivariable model controlling for age and IAS trauma, the presence of at least four abnormal slices gave an 18-fold (95% CI, 9-36; P < 0.0001) increase in the likelihood of AI, compared with those with fewer than four abnormal slices. Using receiver-operating characteristics curve statistics, this model yielded an area under the cur...Continue Reading

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Citations

Mar 1, 2016·BJOG : an International Journal of Obstetrics and Gynaecology·I Kamisan AtanH P Dietz
Apr 22, 2016·Acta Obstetricia Et Gynecologica Scandinavica·Jaan KirssMikael Victorzon
Apr 19, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·C RosM Espuña-Pons
Oct 27, 2016·Female Pelvic Medicine & Reconstructive Surgery·Chandhana PakaHans Peter Dietz
Aug 7, 2017·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·R A Guzmán RojasI Volløyhaug
Sep 12, 2018·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Friyan TurelHans Peter Dietz
Feb 8, 2018·International Urogynecology Journal·Francisco J OrejuelaSusan M Ramin
Nov 15, 2018·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·F Turel FatakiaH P Dietz
Sep 29, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J Melendez-MunozH P Dietz
Aug 6, 2019·Acta Obstetricia Et Gynecologica Scandinavica·Andrea StuartAnn-Kristin Örnö
Jul 5, 2019·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·N Subramaniam, H P Dietz
Sep 9, 2019·International Urogynecology Journal·Yanping LiHans Peter Dietz
Oct 13, 2019·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·N Subramaniam, H P Dietz
Oct 27, 2016·Female Pelvic Medicine & Reconstructive Surgery·Ka Lai ShekHans Peter Dietz
Mar 10, 2020·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·M GillorH P Dietz
Jul 28, 2016·Current Opinion in Obstetrics & Gynecology·Hans P DietzIan Milsom
Jan 16, 2019·International Urogynecology Journal·Laura CattaniHans Peter Dietz
Jun 15, 2020·International Urogynecology Journal·Jessica Caudwell HallHans Peter Dietz
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Dec 10, 2019·International Urogynecology Journal·Nishamini SubramaniamHans Peter Dietz
Jan 6, 2021·International Urogynecology Journal·Aurore FehlmannMarie-Eve Clermont
Dec 29, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Eva Martinez FrancoMontserrat Espuña
Feb 18, 2021·International Urogynecology Journal·Hans Peter Dietz
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Sep 23, 2020·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·Z MengistuH P Dietz
Jun 16, 2021·American Journal of Obstetrics & Gynecology MFM·Federica Bellussi, Hans Peter Dietz
Aug 8, 2021·Journal of Clinical Medicine·Antonino SpinelliKatarzyna Borycka-Kiciak

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