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Obstetric anal sphincter injury: a follow-up questionnaire study on longer-term outcomes

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Abstract

Introduction and hypothesis

Obstetric anal sphincter injuries (OASIS) contribute significantly to the development of anal incontinence (AI) in women. The aim of this study was to establish the incidence of AI after OASIS and to study the influence on the quality of life (QoL) in patients with OASIS.

Methods

This cohort study, with prospective case-control follow-up, involves women who were treated for OASIS between 2005 and 2012 in two academic medical centers in The Netherlands. Three hundred and thirteen patients and 780 controls were invited to complete a validated questionnaire (Defecation Distress Inventory, Wexner Incontinence Score, and Fecal Instrument Quality of Life) regarding symptoms and bother of AI subsequent and QoL after delivery. The main outcome measures were the presence of AI and the impact on QoL.

Results

The questionnaire was completed by 141 patients and 194 controls. Mean follow-up was 4 years (range 1–9 years) in both groups. In the patient group, 55 women (39 %) reported AI symptoms compared with 38 women (20 %) in the control group (odds ratio 2.7, 95 % confidence interval 1.66–4.47, p < 0.01). In women who experienced symptoms of AI as very bothersome, QoL was affected in 14 (82.0 %) patients and three (33.5 %) controls (p = 0.012).

Conclusions

In this study, women with OASIS had a more than doubled risk of longer-term bothersome symptoms of AI compared with controls. Symptoms were experienced as bothersome and as having an influence on QoL.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Medical University Centre Maastricht, Maastricht, The Netherlands

    Simone Cornelisse

  2. Department of Obstetrics and Gynaecology, Radboud University Nijmegen, Nijmegen, The Netherlands

    Linda Petra Arendsen

  3. Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands

    Sander Martijn Job van Kuijk

  4. Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Kirsten Birgit Kluivers & Jeroen van Dillen

  5. Department of Obstetrics and Gynaecology, Zuyderland ziekenhuis, Heerlen, The Netherlands

    Mirjam Weemhoff

Authors
  1. Simone Cornelisse
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  2. Linda Petra Arendsen
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  3. Sander Martijn Job van Kuijk
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  4. Kirsten Birgit Kluivers
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  5. Jeroen van Dillen
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  6. Mirjam Weemhoff
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Corresponding author

Correspondence to Mirjam Weemhoff.

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Conflict of interest

The authors declare that they have no conflict of interest.

Details of ethics approval

Ethics approval was obtained from the Medical Ethics Board form the Maastricht University Medical Centre on 06-06-2014 (REB number:14-02-002)

The Medical Ethics board of the Radboud University Nijmegen Medical Centre, gave approval to the study design without submission of the protocol.

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Cornelisse, S., Arendsen, L.P., van Kuijk, S.M.J. et al. Obstetric anal sphincter injury: a follow-up questionnaire study on longer-term outcomes. Int Urogynecol J 27, 1591–1596 (2016). https://doi.org/10.1007/s00192-016-3017-5

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  • DOI: https://doi.org/10.1007/s00192-016-3017-5

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