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Outcome of obstetric anal sphincter injuries (OASIS)—role of structured management

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Abstract

Introduction and hypothesis

Prospective studies up to 1 year after repair of obstetric anal sphincter injuries (OASIS) report anal incontinence in 33% of women and up to 92% have a sonographic sphincter defect. The aim of this study is to determine the outcome of repair by doctors who have undergone structured training using a standardized protocol.

Methods

Doctors repaired OASIS after attending a training workshop. The external anal sphincter was repaired by the end-to-end technique when partially divided and the overlap method when completely divided. Endoanal ultrasound was performed prior to suturing and 7 weeks later. A validated bowel symptom questionnaire was completed prior to delivery, at 7 weeks postpartum, and at 1 year postpartum.

Results

Fifty-nine women sustained OASIS. At 7 weeks, six (10%) had a defect on ultrasound. There was no significant deterioration in symptoms of fecal urgency, incontinence, or quality of life at 1 year after delivery.

Conclusions

The 1-year outcome after repair of OASIS appears to be good when repaired by doctors after structured training.

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Acknowledgements

We would like to thank the Mayday Childbirth Charity Fund for funding this study.

Disclosure of interest

AS and RT are the directors of the hands-on workshops in the management of third-degree and fourth-degree tears at Mayday University Hospital, and proceeds from these courses are utilized by the Mayday Childbirth Charitable Research Fund.

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Authors and Affiliations

  1. Mayday University Hospital, London Road, Croydon, Surrey, CR7 7YE, UK

    Vasanth Andrews, Ranee Thakar & Abdul H. Sultan

Authors
  1. Vasanth Andrews
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  2. Ranee Thakar
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  3. Abdul H. Sultan
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Corresponding author

Correspondence to Abdul H. Sultan.

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Andrews, V., Thakar, R. & Sultan, A.H. Outcome of obstetric anal sphincter injuries (OASIS)—role of structured management. Int Urogynecol J 20, 973–978 (2009). https://doi.org/10.1007/s00192-009-0883-0

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  • DOI: https://doi.org/10.1007/s00192-009-0883-0

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