Can women with intrapartum rupture of anal sphincter still suffer after-effects two decades later?

Recent research has revealed that women who suffer anal sphincter rupture (ASR) during delivery can experience persisting complaints some time afterwards. Examinations have been made some years postpartum, but it would be of interest to know if women with anal sphincter rupture might still have complaints attributable to the tear, two decades later.

A questionnaire was mailed to women with recorded intrapartum anal sphincter rupture (n = 66) and to matched controls without anal sphincter rupture (n = 66), two decades after the event.

Forty-one of the anal sphincter rupture women and 38 controls replied. Anal problems were more often experienced by the anal sphincter rupture subjects (n = 18) than by the controls (n = 7) (P < 0.01). Complaints such as anal fissures, gas incontinence and leakage into lingerie were significantly more common in the sphincter rupture group. Four claimed the physic trauma had deterred them from further pregnancy; two had nevertheless given birth later on. Five (12%) of the women were unaware that they had sustained a sphincter tear.

Women with intrapartum anal sphincter rupture can still suffer problems 20 years afterwards. In the follow-up of these women, information and support are essential and active tracing of such women is to be recommended.