Techniques for Repair of Obstetric Anal Sphincter Injuries

Meister, Melanie; Rosenbloom, Joshua I.; Lowder, Jerry L.; Cahill, Alison G.

doi:10.1097/ogx.0000000000000521

Cited by 22 publications

(23 citation statements)

References 34 publications

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“…Currently, there is no research studying this association. While postpartum surgery is usually carried out to repair a structure or function to recover normality [ 49 ] and thereby improve the quality of life of the patient, the presence of injury and the sequelae derived from the intervention to repair it may increase the risk of developing PTSD.…”

Section: Discussionmentioning

confidence: 99%

Long-Term High Risk of Postpartum Post-Traumatic Stress Disorder (PTSD) and Associated Factors

Martínez‐Vázquez

Rodríguez‐Almagro

Hernández‐Martínez

et al. 2021

JCM

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Postpartum post-traumatic stress disorder (PTSD) is not a specific process but can last for months and may manifest itself during any subsequent pregnancies or even become chronic. This study aimed to determine the factors associated with long-term PTSD symptoms one year after delivery. A cross-sectional study was conducted on 1301 Spanish puerperal women. Data were collected on sociodemographic, obstetric, and neonatal variables. The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was administered online through midwives’ associations across Spain. Crude odds ratio (OR) and adjusted odds ratio (aOR) and their 95% confidence intervals were calculated. A PPQ score ≥ 19 (high-risk) was recorded for 13.1% (171) of the participants. Identified risk factors were not respecting a birth plan (aOR = 1.89 (95% CI 1.21–2.94)), formula-feeding of the baby at discharge (aOR = 2.50 (95% CI 1.20–5.17)), postpartum surgical intervention (aOR = 2.23 (95% CI 1.02–4.85)), hospital readmission (aOR = 3.45 (95% CI 1.21–9.84)), as well as verbal obstetric violence (aOR = 3.73 (95% CI 2.52–5.53)) and psycho-affective obstetric violence (aOR = 3.98 (95% CI 2.48–6.39)). During childbirth, some clinical practices, such as formula-feeding of the newborn at discharge or types of obstetric violence towards the mother, were associated with a higher risk of PTSD symptoms one year after delivery.

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Section: Discussionmentioning

confidence: 99%

Long-Term High Risk of Postpartum Post-Traumatic Stress Disorder (PTSD) and Associated Factors

Martínez‐Vázquez

Rodríguez‐Almagro

Hernández‐Martínez

et al. 2021

JCM

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“…However, most of the traumas were associated with obstetric injuries. Previous reviews 15,16 mainly analyzed only obstetric anal sphincter injuries. The study conducted by Khafagy et al 9 has the most diverse etiologies, including anal fistula, perineal necrotizing fasciitis, trauma after hemorrhoidectomy, and injuries following stricturotomy for anal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Short- and Long-Term Outcomes of Overlap Anal Sphincter Repair for Fecal Incontinence Following Sphincter Injury

Lakmal

Basnayake

Jayarajah

et al. 2021

Journal of Coloproctology

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Objective Several techniques are used to repair the anal sphincter following injury. The aim of the present study is to comprehensively analyze the short- and long-term outcomes of overlap repair following anal sphincter injury. Methods A search was conducted in the PubMed, Medline, Embase, Scopus and Google Scholar databases between January 2000 and January 2020. Studies that described the outcomes that are specific to overlap sphincter repair for fecal incontinence with a minimum follow-up period of one year were selected. Results A total of 22 studies described the outcomes of overlap sphincter repair. However, 14 studies included other surgical techniques in addition to overlap repair, and were excluded from the analysis. Finally, data from 8 studies including 429 repairs were analyzed. All studies used at least one objective instrument; however, there was significant heterogeneity among them. Most patients were female (n = 407; 94.87%) and the mean age of the included individuals was 44.6 years. The majority of the procedures were performed due to obstetric injuries (n = 384; 89.51%). The eight included studies described long-term outcomes, and seven of them demonstrated statistically significant improvements regarding the continence; one study described poor outcomes in terms of overall continence. The long-term scores were significantly better compared with the preoperative scores. However, compared with the short-term scores, a statistically significant deterioration was noted in the long-term. Conclusion The majority of the studies described good long-term outcomes in terms of anal continence after overlap sphincter repair. However, further studies are needed to identify the factors associated with poor outcomes to assist in patient selection for overlap repair.

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“…Pastikan jahitan dengan cara rectal touche 10. Akhiri dengan menutup luka jahitan menggunakan kasa (Meister et al, 2018). Gambar 4.…”

Section: Tatalaksana Ruptur Perineumunclassified

Ruptur Perineum Grade 3A Post Trauma: Laporan Kasus

Hardiyanti

Islamy²,

Sayuti³

2022

JIMI

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Purpose: This study aimed to summarize the general history, physical findings, and treatment of a patient with traumatic perineal tears grade 3A. Research Methodology: A case report from Obstetrics and Gynecology RSUD Abdoel Moeloek Lampung. The subject of this study is a 9-year-old girl, hospitalized in the hospital ward with traumatic perineal tears grade 3A. Result: A 9-year-old girl complaints of vaginal bleeding after an accident 4 hours before hospitalization. On physical examination, in perineum region found vulnus laceratum regio perineum size 4 x 1 cm to external anal sphincter <50%, hymen rupture (+), bleeding and blood clot (+), rectal touch revealed anal sphincter tone (+) decreased, laceration of anal sphincter <50%. The patient was clinically diagnosed with “Traumatic Perineal Tears Grade 3A”. Definitive management is operative to repair lacerations under general anesthesia. Limitations: This case is limited to traumatic perineal tears grade 3A cases which is a rare case in children. Contribution: This article can be helpful in medical education or as a reference in making relevant case reports. Keywords: 1. Traumatic Perineal Tears Grade 3A 2. Pediatrics 3. Operative 4. General Anesthesia

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Techniques for Repair of Obstetric Anal Sphincter Injuries

Abstract: Long-term sequelae, including pain, dyspareunia, and fecal incontinence, significantly impact quality of life for many patients who suffer OASISs and may be avoided if evidence-based guidelines for recognition and repair are utilized.

Cited by 22 publications

References 34 publications

Long-Term High Risk of Postpartum Post-Traumatic Stress Disorder (PTSD) and Associated Factors

Long-Term High Risk of Postpartum Post-Traumatic Stress Disorder (PTSD) and Associated Factors

Short- and Long-Term Outcomes of Overlap Anal Sphincter Repair for Fecal Incontinence Following Sphincter Injury

Ruptur Perineum Grade 3A Post Trauma: Laporan Kasus

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