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Anal sphincter repair in patients with obstetric trauma: age affects outcome
O O Rasmussen1, L Puggaard, J Christiansen
1Department of Surgery D, Herlev Hospital, University of Copenhagen, Denmark.
Insights
Advancing age negatively impacts anal sphincter repair outcomes for women with obstetric trauma and fecal incontinence. Younger patients experienced significantly better results following the surgical procedure.
Area of Science:
- Obstetrics and Gynecology
- Colorectal Surgery
- Geriatric Medicine
Background:
- Fecal incontinence is a common complication following obstetric trauma.
- Anal sphincter repair is a surgical option for managing fecal incontinence.
- The impact of patient age on surgical outcomes for anal sphincter repair is not well-established.
Purpose of the Study:
- To investigate the influence of advancing age on the success rates of anal sphincter repair in patients who have experienced obstetric trauma and subsequent fecal incontinence.
Main Methods:
- A retrospective study comparing two groups of patients undergoing anal sphincter repair: those younger than 40 years and those older than 40 years.
- All patients included in the study had a history of obstetric trauma leading to fecal incontinence.
Main Results:
- A significantly higher proportion of patients younger than 40 years achieved continence or incontinence to flatus only (83%) compared to those older than 40 years (43%).
- Patients over 40 years old demonstrated a poorer functional outcome, with a 40% difference observed between the age groups.
- The confidence interval for the difference in functional outcome between younger and older patients was 10-70%.
Conclusions:
- Advancing age is associated with a poorer outcome after anal sphincter repair in women suffering from fecal incontinence due to obstetric trauma.
- Younger women are more likely to experience successful functional improvement following anal sphincter repair compared to older women.
Purpose:
This study was designed to determine whether advancing age affects the outcome of anal sphincter repair in patients with obstetric trauma and fecal incontinence.
Methods:
Anal sphincter repair was performed on 24 patients younger than 40 (median age, 30) years and on 14 patients older than 40 (median age, 57) years. All patients had previous obstetric trauma.
Results:
Twenty patients younger than 40 years (83 percent; 95 percent confidence interval, 63-95 percent) became continent, or incontinent to flatus only, after anal sphincter repair, whereas four patients had unchanged incontinence. Among patients older than 40 years, six patients (43 percent; 95 percent confidence interval, 18-71 percent) became continent, whereas eight patients remained incontinent (40 percent difference in functional outcome between younger and older patients; 95 percent confidence interval, 10-70 percent).
Conclusion:
Older females have a poorer outcome of anal sphincter repair for obstetric trauma compared with younger females.