Pelvic floor dysfunction 6 years post-anal sphincter tear at the time of vaginal delivery

Int Urogynecol J. 2011 Sep;22(9):1127-34. doi: 10.1007/s00192-011-1431-2. Epub 2011 Apr 22.


Introduction and hypothesis: This study aims to estimate fecal, urinary incontinence, and sexual function 6 years after an obstetrical anal sphincter tear.

Methods: Among 13,213 women who had a vaginal delivery of a cephalic singleton at term, 196 women sustained an anal sphincter tear. They were matched to 588 controls. Validated questionnaires grading fecal and urinary incontinence, and sexual dysfunction were completed by the participants.

Results: Severe fecal incontinence was more frequently reported by women who had sustained an anal sphincter tear compared to the controls. Women with an anal sphincter tear had no increased risk of urinary incontinence, but reported significantly more pain, difficulty with vaginal lubrication, and difficulty achieving orgasm compared to the controls. A fetal occiput posterior position during childbirth was an independent risk factor for both severe urinary incontinence and severe sexual dysfunction.

Conclusions: Fecal incontinence is strongly associated with an anal sphincter tear. A fetal occiput posterior position represents a risk factor for urinary incontinence and sexual dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anal Canal / injuries*
  • Anal Canal / surgery
  • Case-Control Studies
  • Extraction, Obstetrical / adverse effects*
  • Fecal Incontinence / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Labor Presentation
  • Logistic Models
  • Pelvic Floor Disorders / etiology
  • Pregnancy
  • Risk Factors
  • Severity of Illness Index
  • Sexual Dysfunction, Physiological / etiology*
  • Surveys and Questionnaires
  • Urinary Incontinence / etiology*