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[Manometric and clinical long-term outcome after grade III perineal rupture]
C Anthuber1, S Anthuber, B Föst
1Klinik und Poliklinik Für Frauenheikunde und Geburtshilfe, Klinikum Grosshadern.
Objective:
To investigate the manometrical and clinical long-term results following a tear III.
Patients:
27 Primiparae with a tear III following a spontaneous vaginal delivery were retrospectively compared with 22 Primiparae without sphincter injury (follow-up: 27 months).
Methods:
Water-Perfusion-Manometry and clinical assessment (modified Kelly-Score). Manometric parameter (at rest and during contraction): sphinctertone and - length, vectorvolume, radial asymmetry. Wilcoxon-Text (p < 0.05).
Results:
Tear III patients showed a significant decrease in sphincter length and vector volume both at rest and during contraction. On clinical assessment there was no difference.
Conclusion:
A tear III weakens the anal sphincter by decreasing sphincter length and vector volume. This weakness can be demonstrated only manometrically but not clinically.