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Management of obstetric anal sphincter injury

Mayday University Hospital, Corydon, UK.

Abdul H Sultan, MD MRCOG, Consultant Obstetrician and Gynaecologist

Department of Obstetrics and Gynaecology, Mayday University Hospital, London Road, Croydon CR7 7YE. UK. email: abdul.sult.n{at}mayday.nhs.uk (corresponding author)

Obstetric anal sphincter trauma is the most common cause of faecal incontinence and can have a devastating effect on quality of life. Therefore, recognition of the tear is of utmost importance. However, despite repair, up to 59% of women suffer from impaired faecal continence. Poor technique and inadequate training are important contributing factors. This article provides guidelines for safe clinical practice and discusses options for the management of subsequent pregnancy. There is a need for more focused training in perineal anatomy and anal sphincter repair.

Keywords Keywords / anal sphincter / incontinence / third-degree tear