Morphological differences in the female anal sphincter complex between endoanal and exoanal ultrasound

Wen, Liang; Zhao, Baihua; Tang, Yingchun; Guo, Yuyang; Xiao, Xian

doi:10.1007/s00192-022-05341-z

Cited by 2 publications

(3 citation statements)

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“…Median parity was 2 (IQR: 1, 2). The mean age at the first delivery was 23.4 AE 3.0 years (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Significant AI symptoms were found in 29 patients (14.8%) with a mean SMIS of 12.1 AE 4.5 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Resultsmentioning

confidence: 99%

“…[17][18][19][20] TPUS with TUI is a noninvasive and easily accessible method. 11,12,18,22 Many studies have shown TPUS to be a valuable modality for assessing postpartum OASI and investigating major sphincter defects related to AI. [23][24][25] The diagnostic utility of TPUS has increased with mounting awareness of the significance of childbirth trauma.…”

Section: Discussionmentioning

confidence: 99%

“…The assessment of OASI is essential for the evaluation of AI and for advice on future births 17–20 . TPUS with TUI is a noninvasive and easily accessible method 11,12,18,22 . Many studies have shown TPUS to be a valuable modality for assessing postpartum OASI and investigating major sphincter defects related to AI 23–25 .…”

Section: Discussionmentioning

confidence: 99%

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Assessing Obstetric Anal Sphincter Injuries

Zhao

Tang³

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo explore the differences in assessing obstetric anal sphincter injuries (OASI) between transperineal ultrasound (TPUS) and endoanal ultrasound (EAUS) and test relationships between ultrasound findings and anal incontinence (AI) symptoms.MethodsA group of 196 women with a history of vaginal delivery was recruited. OASI was detected in a set of 5 slices by EAUS and 8 slices by TPUS. OASI grading was performed on TPUS rules and EAUS rules. A “significant sphincter defect” was diagnosed by TPUS and EAUS using “2/3 rules.” Symptoms of AI were determined using the St Mark's Incontinence Score (SMIS). Ultrasound findings were compared between the two methods and correlated with symptoms.ResultsOf 196 women, 29 (14.8%) suffered from AI with a mean SMIS of 12.1 ± 4.5, and 70 (35.7%) women with a mean age of 57 years had suspected OASI on imaging. Twenty‐one (10.7%) “significant defects” were diagnosed by TPUS and 24 (12.2%) by EAUS. OASI Grades on TPUS had good agreement with EAUS rules (k = 0.70, P < .001). Logistic regression analysis showed that OASI Grade on imaging and “significant sphincter defects” seen on both forms of imaging were associated with AI symptoms. The odds ratio was 46 and 38 for “significant defects” on TPUS and EAUS, and 14 and 7 for OASI 3b+ on TPUS and EAUS in predicting AI, respectively.Conclusions“Significant defects” diagnosed by EAUS or TPUS and OASI Grade 3b+ predict AI symptoms. The diagnostic performance of endoanal and exoanal ultrasound (EAUS and TPUS) appear to be very similar.

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