Related Experiment Video
Updated: Aug 17, 2026

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Long-term consequences of first vaginal delivery-induced anal sphincter defect
Henri Damon1, Stephan Bretones, Luc Henry
1Fédération des Spécialités Digestives, Hôpital E. Herriot, Lyon, France.
Purpose:
This study was designed to investigate the long-term consequences of anal sphincter defects detected after a first vaginal delivery.
Methods:
A cohort of 197 primiparous females was evaluated for anal continence and anal sphincter defects in 1997. In June 2003 (6 years later), a postal questionnaire was sent to 74 females of this cohort, and answers from 54 (73 percent) were analyzed.
Results:
In 1997, a transanal ultrasound found 66 anal sphincter defects (33.5 percent). Twenty-one females (10.6 percent) had persistent signs of anal incontinence 12 weeks after the index delivery. There was a significant correlation between the presence of anal sphincter defect and anal incontinence. Six years later, 11 of 54 females reported signs of anal incontinence: 50 percent of females with anal sphincter defect and only 8.1 percent of females without (P = 0.002). Large defects were more frequently associated with anal incontinence. Anal incontinence after the index vaginal delivery also was significantly associated with anal incontinence six years later. Multivariate analysis showed anal sphincter defect to be the only variable predictive of anal incontinence (odds ratio, 10.5; 95 percent confidence interval, 2.1-52.4).
Conclusions:
Anal sphincter defects detected after the first vaginal delivery appear as the main risk factor for anal incontinence six years later.
Related Concept Videos
Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Development of the Oral Microbiota
Varicose Veins I: Introduction
Intestinal Obstruction II: Pathophysiology