OBJECTIVE
Our goal was to evaluate sexual function following anal sphincteroplasty in women with third and fourth degree perineal tears secondary to birth trauma.
METHODS
Our study was performed using a retrospective cohort design in a group of women (n = 32) who had experienced either third-degree or fourth-degree perineal tears during labor and then elected to undergo sphincteroplasty for fecal incontinence. We surveyed our patients with a questionnaire that was developed by the Obstetrics and Gynecology Epidemiology Center at Harvard Medical School and was previously used to survey women with obstetric injuries. Self-reported presphincteroplasty and postsphincteroplasty degree of physical sensation, sexual satisfaction, and likelihood of achieving orgasm were measured. Also measured were libido, partner satisfaction, and presence of emotional or physical inability to engage in sexual behavior.
RESULTS
Our results reaffirmed the findings of the Obstetrics and Gynecology Epidemiology Center’s study that sexual function is compromised in women with third and fourth degree perineal tears. For our patients with this degree of perineal tearing who underwent sphincteroplasty after primary repair, our survey showed consistent improvement in several parameters of sexual function. After sphincteroplasty, physical sensation was higher /much higher in 40 percent, sexual satisfaction was better/much better in 33.3 percent, and 28.6 percent of the patients were more/much more likely to reach orgasm. Libido was improved in 37.5 percent of the study population, and 20 percent reported increased partner satisfaction. Before surgery, 23.5 percent of patients were physically and 31.2 percent emotionally unable to participate in sexual activity because of fear of incontinence or intimacy; after surgery only 6.3 percent were physically unable and 0 percent were emotionally unable to engage in sexual activity. The response rate for our study was 18/32 (56 percent).
CONCLUSIONS
Anal sphincteroplasty for the treatment of incontinence in women with third and fourth degree perineal tears improves physical and emotional sexual well-being and function.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
AH Sultan MA Kamm CN Hudson CI Bartram (1994) ArticleTitleThird degree obstetric and anal sphincter tears: risk factors and outcome of primary repair BMJ 308 887–91 Occurrence Handle1:STN:280:ByuB38jlvVQ%3D Occurrence Handle8173367
MB Nielsen C Hauge OO Rasmussen JF Pedersen J Christiansen (1992) ArticleTitleAnal endosonographic findings in the follow-up of primarily sutured sphincteric ruptures Br J Surg 79 104–6 Occurrence Handle1:STN:280:By2B3cfms10%3D Occurrence Handle1555052
M Sorensen T Tetzschner OO Rasmussen J Bjarnesen J Christiansen (1993) ArticleTitleSphincter rupture in childbirth Br J Surg 80 392–4 Occurrence Handle1:STN:280:ByyB3s%2FktFc%3D Occurrence Handle8472162
M Fitzpatrick M Behan PR O’Connell C O’Herlihy (2000) ArticleTitleA randomized clinical trial comparing primary overlap with approximation repair of third-degree obstetric tears Am J Obset Gynecol 183 1220–4 Occurrence Handle10.1067/mob.2000.108880 Occurrence Handle1:STN:280:DC%2BD3M%2FkvF2ltg%3D%3D
S Karoui AM Leroi E Koning JF Menard F Michot P Denis (2000) ArticleTitleResults of sphincteroplasty in 86 patients with anal incontinence Dis Colon Rectum 43 813–20 Occurrence Handle1:STN:280:DC%2BD3czhsFKitw%3D%3D Occurrence Handle10859083
G Barisic Z Krivokapic V Markovic M Popovic D Saranovic A Marsavelska (2002) ArticleTitleThe role of overlapping sphincteroplasty in traumatic fecal incontinence. Acta Chir Iugosl 47(4 Suppl 1) 37–41
A Osterberg K Edebol Eeg-Olofsson W Graf (2000) ArticleTitleResults of surgical treatment for faecal incontinence Br J Surg 87 1546–52 Occurrence Handle10.1046/j.1365-2168.2000.01568.x Occurrence Handle1:STN:280:DC%2BD3M%2FltFOhsA%3D%3D Occurrence Handle11091244
H Matsuoka C Mavrantonis SD Wexner L Oliveira R Gilliland A Pikarsky (2000) ArticleTitlePostanal repair for fecal incontinence–is it worthwhile? Dis Colon Rectum 43 1561–7 Occurrence Handle1:STN:280:DC%2BD3M%2Fkt1Gitw%3D%3D Occurrence Handle11089593
NA Rotholtz SD Wexner (2001) ArticleTitleSurgical treatment of constipation and fecal incontinence Gastroenterol Clin North Am 30 131–66 Occurrence Handle1:STN:280:DC%2BD3Mzis12lsw%3D%3D Occurrence Handle11394027
LB Signorello BL Harlow AK Chekos JT Repke (2001) ArticleTitlePostpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women Am J Obstet Gynecol 184 881–90 Occurrence Handle10.1067/mob.2001.113855 Occurrence Handle1:STN:280:DC%2BD3Mzgslykuw%3D%3D Occurrence Handle11303195
TL Hull C Floruta M Piedmonte (2001) ArticleTitlePreliminary results of an outcome tool used for evaluation of surgical treatment for fecal incontinence Dis Colon Rectum 44 799–805 Occurrence Handle1:STN:280:DC%2BD3MzhvFOqsQ%3D%3D Occurrence Handle11391139
Author information
Authors and Affiliations
Additional information
Reprints are not available.
About this article
Cite this article
Lewicky, C., Valentin, C. & Saclarides, T. Sexual Function Following Sphincteroplasty for Women With Third-Degree and Fourth-Degree Perineal Tears. Dis Colon Rectum 47, 1650–1654 (2004). https://doi.org/10.1007/s10350-004-0648-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10350-004-0648-2