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Related Experiment Videos

Delayed external sphincter repair for obstetric tear.

S Laurberg1, M Swash, M M Henry

  • 1Sir Alan Parks Physiology Unit, St. Mark's Hospital, London, UK.

The British Journal of Surgery
|August 1, 1988
PubMed
Summary

Surgical repair of obstetric anal sphincter tears is less successful when patients have nerve damage. Pre-operative physiological testing can predict surgical outcomes for fecal incontinence treatment.

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Area of Science:

  • Obstetrics and Gynecology
  • Colorectal Surgery
  • Neuroscience

Background:

  • Obstetric tears can cause anal sphincter weakness and fecal incontinence.
  • Nerve damage (neuropathy) to the anal sphincter muscles can occur during delivery.
  • Delayed surgical repair is sometimes required for these injuries.

Purpose of the Study:

  • To investigate the impact of pudendal nerve damage on the success of delayed surgical repair for obstetric anal sphincter tears.
  • To determine if pre-operative physiological evaluation can predict surgical outcomes.

Main Methods:

  • Retrospective analysis of 19 patients undergoing delayed surgical repair for obstetric sphincter tears.
  • Pre-operative anorectal physiological investigations to assess for pudendal nerve damage.

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  • Evaluation of surgical outcomes (excellent or good results).

    • Main Results:

    • 47% of patients showed evidence of pudendal nerve damage pre-operatively.
    • Surgical repair success was significantly higher in patients without nerve damage (80%) compared to those with nerve damage (11%).
    • Pudendal nerve damage was a significant predictor of poor surgical outcomes (P = 0.018).

    Conclusions:

    • The functional outcome of delayed anal sphincter repair is influenced by the integrity of the nerve supply.
    • Pre-operative physiological evaluation is crucial for predicting the likelihood of successful surgical intervention in these cases.