Prise en charge et conséquences des lésions obstétricales du sphincter anal (LOSA) : mise au point

Viannay, P.; Codre, F. de la; Brochard, Charlène; Thubert, Thibault; Meurette, G.; Legendre, Guillaume; Venara, Aurélien

doi:10.1016/j.jchirv.2020.07.128

Cited by 1 publication

(2 citation statements)

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“…These perineal lacerations can impact women's quality of life with anal incontinence, perineal pain, dyspareunia, recto-vaginal fistula, and depression. 1,2 The rate of obstetrical anal sphincter injuries varies between 0.25% and 6% depending on the study. 3 Data concerning the mechanical properties of the perineum and fetal stresses during delivery are very limited.…”

Section: Introductionmentioning

confidence: 99%

“…Third‐ and fourth‐degree tears correspond to obstetrical lesions of the anal sphincter and/or anal mucosa. These perineal lacerations can impact women's quality of life with anal incontinence, perineal pain, dyspareunia, recto‐vaginal fistula, and depression 1,2 . The rate of obstetrical anal sphincter injuries varies between 0.25% and 6% depending on the study 3 …”

Section: Introductionmentioning

confidence: 99%

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In vitro biomechanical properties of porcine perineal tissues to better understand human perineal tears during delivery

Lallemant,

Kadiakhe,

Chambert

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionData concerning the mechanical properties of the perineum during delivery are very limited. In vivo experiments raise ethical issues. The aim of the study was to describe some of the biomechanical properties of each perineal tissue layer collected from sows in order to better understand perineal tears during childbirth.Material and methodsSamples of each perineal tissue layer were obtained from the skin, the vagina, the external anal sphincter (EAS), the internal anal sphincter (IAS), and the anal mucosa of fresh dead sows. They were tested in quasi‐static uniaxial tension using the testing machine Mach‐1®. Tests were performed at a displacement velocity of 0.1 mm·s−1. Stress–strain curves of each perineal tissue layer before the first damage for each sow were obtained and modeled using a hyperelastic Yeoh model described by three coefficients: C1, C2, and C3. Pearson correlation coefficients were calculated to measure the correlation between the C1 hyperelastic coefficient and the duration between the first microfailure and the complete rupture for each perineal tissue layer. Pearson correlation was computed between C1 and the number of microfailures before complete rupture for each tissue.ResultsTen samples of each perineal tissue layer were analyzed. Mean values of C1 and corresponding standard deviations were 46 ± 15, 165 ± 60, 27 ± 10, 19 ± 13, 145 ± 28 kPa for the perineal skin, the vagina, the EAS, the IAS, and the anal mucosa, respectively. According to this same sample order, the first microfailure in the population of 10 sows appeared at an average of 54%, 27%, 70%, 131%, and 22% of strain. A correlation was found between C1 hyperelastic coefficient and the duration between the first microfailure and the complete rupture (r = 0.7, p = 0.02) or the number of microfailures before complete rupture only for the vagina (r = 0.7, p = 0.02).ConclusionsIn this population of fresh dead sow's perineum, the vagina and the anal mucosa were the stiffest tissues. The IAS and EAS were more extensible and less stiff. A significantly positive correlation was found between C1 and the duration between the first microfailure and the complete rupture of the vagina, and the duration between the first microfailure and the complete rupture of the vagina.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%