Evaluation of long-term pelvic floor symptoms after an obstetric anal sphincter injury (OASI) at least one year after delivery: A retrospective cohort study of 159 cases

Gynecol Obstet Fertil. 2016 Jul-Aug;44(7-8):385-90. doi: 10.1016/j.gyobfe.2016.05.007. Epub 2016 Jul 19.

Abstract

Objectives: The aim of this study was to assess long-term pelvic floor symptoms after an obstetric anal sphincter injury (OASI).

Methods: This retrospective cohort study included 237 cases of OASI (0.86% of deliveries) identified at Poitiers University Hospital between 2000 and 2011. Symptoms were assessed using validated self-administered questionnaires, including Female Pelvic Floor Questionnaire, Pescatori anal incontinence score, EuroQoL five-dimension score, and pain visual analogue scale (VAS).

Results: One hundred and sixty women (67%) filled out the questionnaires, on average 46 months after delivery (8-152). Among them, 93 (54%) reported at least one symptom occurring "frequently" (the most common being dyspareunia), and 45 (28%) a symptom occurring "daily" (the most common being flatus incontinence). Anal incontinence was reported by 32 (20%) women, flatus incontinence "frequently" or "daily" by 28 (18%), and stool incontinence "frequently" or "daily" by 9 (6%). Urinary incontinence was reported "frequently" or "daily" by 27 women (17%) at stress, 17 (11%) at urge, and 11 (7%) at mixed circumstances. Prolapse symptoms were reported "frequently" or "daily" by 6 women (4%). Pain during intercourse was reported "frequently" or "daily" by 17 women (11%). Twenty-four women (18%) reported chronic pelvic pain (VAS score≥4/10). Ninety-five percent of women reported a normal quality of life for mobility, self-care, and usual activities; however, alterations in pain/discomfort (32%) and anxiety/depression (33%) domains were frequently reported.

Conclusion: Pelvic floor symptoms 4 years after OASI were highly prevalent.

Keywords: Floor; OASI; Outcome; Pelvic; Post-partum; Postnatal; Périnée; Périnée complet; Questionnaire; Symptomatologie.

MeSH terms

  • Adolescent
  • Adult
  • Anal Canal / injuries*
  • Cohort Studies
  • Delivery, Obstetric / adverse effects*
  • Dyspareunia / epidemiology
  • Fecal Incontinence / epidemiology
  • Female
  • Flatulence / epidemiology
  • Humans
  • Pelvic Floor
  • Pelvic Floor Disorders / epidemiology
  • Pelvic Floor Disorders / etiology*
  • Quality of Life
  • Retrospective Studies
  • Surveys and Questionnaires
  • Urinary Incontinence / epidemiology
  • Young Adult