Dedicated Clinics for Women With Obstetric Anal Sphincter Injuries (OASIs): The Current Landscape in Canada
Ella Barrett-Chan1, Huse Kamencic2, Maria Giroux2
1Faculty of Medicine, University of British Columbia, Vancouver, BC.
Objectives:
Obstetric anal sphincter injuries (OASIs) can significantly affect quality of life. Optimally, these patients receive follow-up in dedicated multidisciplinary clinics with specialized investigations and expert care. Despite the rising incidence of OASIs, there is limited understanding of the availability and scope of dedicated clinics in Canada. This study aimed to identify dedicated OASIs clinics in Canadian academic centres and determine available resources at these sites to guide future development and national resource distribution.
Methods:
A cross-sectional survey was distributed in April 2023 to obstetricians and gynaecologists across 18 Canadian academic centres, inquiring about the presence of dedicated OASIs clinics and resources. Updated information was obtained from clinic websites and by re-contacting clinics and non-respondents in February 2025. Because this was a quality improvement study, Research Ethics Board approval was not required. Data were analyzed using descriptive statistics.
Results:
Responses were received from all 18 academic centres (response rate 100%). Eight dedicated OASIs clinics were identified nationwide. Multidisciplinary teams were present in 62.5% (n = 5/8) of clinics. Endoanal ultrasound was accessible in 100.0% (n = 8/8) and anorectal manometry was accessible in 75.0% (n = 6/8). Four dedicated clinics (50.0%, n = 4/8) provided coverage for pelvic health physiotherapy.
Conclusion:
This is the first Canadian study to map the national distribution of dedicated OASIs clinics. Although several centres have established subspecialized services, many patients with OASIs still lack access to comprehensive multidisciplinary care.
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