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Modified Perineal Reconstruction Combined with Anal Sphincter Repair for Obstetric Anal Sphincter Injuries

Xu Wang1, Yi-Nan Liu1, Di Sun1

  • 1Department of Colorectal Surgery, The First Hospital of Jilin University, Changchun, 130000, People's Republic of China.

Therapeutics and Clinical Risk Management
|August 4, 2022
PubMed

Insights

Modified perineal reconstruction with anal sphincter repair effectively treats obstetric anal sphincter injuries (OASIS), improving anal function and perineal reconstruction for better clinical outcomes.

Area of Science:

  • Colorectal Surgery
  • Gynecology
  • Obstetrics

Background:

  • Obstetric anal sphincter injuries (OASIS) can lead to significant long-term morbidity.
  • Effective surgical management is crucial for restoring anal function and quality of life.

Purpose of the Study:

  • To evaluate the clinical effectiveness of modified perineal reconstruction combined with anal sphincter repair for OASI.
  • To assess the impact of this surgical approach on anal function and perineal integrity.

Main Methods:

  • Retrospective study of 20 patients with OASI undergoing modified perineal reconstruction and anal sphincter repair.
  • Anal function assessment using Williams grade, Wexner score, anorectal manometry, and transrectal ultrasound pre- and post-surgery.

Main Results:

  • Statistically significant improvements in Williams grade and Wexner score post-surgery (P < 0.05).
  • Further improvements in these scores and anal manometry (maximum anal resting pressure, maximum anal systolic pressure, anal defecation pressure) at six months post-surgery (P < 0.05).
  • Postoperative endorectal ultrasound showed well-reconstructed anal sphincters with close imbricated overlapping.

Conclusions:

  • Modified perineal reconstruction with anal sphincter repair yields good clinical outcomes for OASI.
  • This combined approach effectively strengthens anal function and reconstructs the perineum.
  • It represents a viable treatment option for managing female perineal defects resulting from OASI.
Abstract

Keywords:
anal functionbilateral V-Y island flapfecal incontinencemodified perineal reconstructionperineal laceration

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