Year 2019 / Volume 111 / Number 6
Original
Quality of life and 3D-EUS assessment for anal incontinence after childbirth

453-459

DOI: 10.17235/reed.2019.6040/2018

Patricia Tejedor, Ignacio Bodega-Quiroga, Javier Plaza, Mario Ortega López, Carlos Gutierrez, Damian García Olmo, Carlos Pastor,

Abstract
Background: the incidence of obstetric sphincter tears has risen to 15-30% and the prevalence of anal incontinence (AI) symptoms after childbirth may be as high as 40%. The present study evaluates the correlation between obstetric injuries detected by endoanal ultrasound (3D-EUS) and AI symptoms, as well as their impact on the quality of life (QOL) of women after childbirth. Methods: a prospective observational study was performed of pregnant women evaluated before (baseline) and three months after childbirth to ensure the integrity of the anal sphincters and to evaluate possible injuries. The Fecal Incontinence Quality of Life (FIQL) questionnaire and the Cleveland Clinic Score of Incontinence (Wexner) were completed before and after childbirth. The questionnaire results were correlated with an assessment of sphincter defects performed by 3D-EUS. Results: a total of 56 females were included in the study. Overall, 48% developed symptoms of AI after childbirth, with a significant decrease in their FIQL compared to the initial evaluation, 3.9 (0.05) vs 3.4 (0.8), respectively (p = 0.000). In addition, 42% of the cohort presented with some kind of obstetric sphincter defect on the 3D-EUS. Instrumental assisted delivery and the sphincter defects were the only two significant factors identified via multivariate analysis that were associated with a decrease in QOL (0.4, 95% CI, 0.07-0.8). Conclusions: AI after childbirth was associated with a huge impact on QOL, especially in patients with sphincter injuries. A complete clinical evaluation, including 3D-EUS, is recommended to prevent, manage or treat AI in primiparous females.
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Tejedor P, Bodega-Quiroga I, Plaza J, Ortega López M, Gutierrez C, García Olmo D, et all. Quality of life and 3D-EUS assessment for anal incontinence after childbirth. 6040/2018


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Publication history

Received: 11/11/2018

Accepted: 17/12/2018

Online First: 25/04/2019

Published: 07/06/2019

Article revision time: 33 days

Article Online First time: 165 days

Article editing time: 208 days


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