International Urogynecology Journal

, Volume 27, Issue 10, pp 1591–1596 | Cite as

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

  • Simone Cornelisse
  • Linda Petra Arendsen
  • Sander Martijn Job van Kuijk
  • Kirsten Birgit Kluivers
  • Jeroen van Dillen
  • Mirjam WeemhoffEmail author
Original Article


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.


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.


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).


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.


Anal incontinence Follow-up Obstetric anal sphincter injury Quality of life 


Compliance with ethical standards

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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Copyright information

© The International Urogynecological Association 2016

Authors and Affiliations

  • Simone Cornelisse
    • 1
  • Linda Petra Arendsen
    • 2
  • Sander Martijn Job van Kuijk
    • 3
  • Kirsten Birgit Kluivers
    • 4
  • Jeroen van Dillen
    • 4
  • Mirjam Weemhoff
    • 5
    Email author
  1. 1.Department of Obstetrics and GynaecologyMedical University Centre MaastrichtMaastrichtThe Netherlands
  2. 2.Department of Obstetrics and GynaecologyRadboud University NijmegenNijmegenThe Netherlands
  3. 3.Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA)Maastricht University Medical CentreMaastrichtThe Netherlands
  4. 4.Department of Obstetrics and GynaecologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  5. 5.Department of Obstetrics and GynaecologyZuyderland ziekenhuisHeerlenThe Netherlands

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