Obstetrical anal sphincter laceration and anal incontinence 5-10 years after childbirth

Am J Obstet Gynecol. 2012 Nov;207(5):425.e1-6. doi: 10.1016/j.ajog.2012.06.055. Epub 2012 Jun 29.


Objective: The purpose of this study was to investigate the long-term impact of anal sphincter laceration on anal incontinence.

Study design: Five to 10 years after first delivery, anal incontinence and other bowel symptoms were measured with the Epidemiology of Prolapse and Incontinence Questionnaire and the short form of the Colorectal-Anal Impact Questionnaire. Obstetric exposures were assessed with review of hospital records. Symptoms and quality-of-life impact were compared among 90 women with at least 1 anal sphincter laceration, 320 women who delivered vaginally without sphincter laceration, and 527 women who delivered by cesarean delivery.

Results: Women who sustained an anal sphincter laceration were most likely to report anal incontinence (odds ratio, 2.32; 95% confidence interval, 1.27-4.26) and reported the greatest negative impact on quality of life. Anal incontinence and quality-of-life scores were similar between women who delivered by cesarean section and those who delivered vaginally without sphincter laceration.

Conclusion: Anal sphincter laceration is associated with anal incontinence 5-10 years after delivery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anal Canal / injuries*
  • Delivery, Obstetric / methods
  • Delivery, Obstetric / statistics & numerical data
  • Fecal Incontinence / epidemiology
  • Fecal Incontinence / etiology*
  • Fecal Incontinence / psychology
  • Female
  • Health Surveys / statistics & numerical data
  • Humans
  • Incidence
  • Lacerations / complications*
  • Lacerations / epidemiology
  • Prevalence
  • Quality of Life / psychology
  • Surveys and Questionnaires