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Overlap Technique Improves Results of Primary Surgery after Obstetric Anal Sphincter Tear

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

This study was designed to evaluate prospectively the results of the overlap technique in primary sphincter reconstruction after obstetric tear.

Methods

Obstetric tears in 44 women were operated on with primary overlap reconstruction. These women were investigated six to nine months after the operation. Results were compared with those of a historical control group of 52 women whose obstetric sphincter rupture had been treated with the end-to-end technique.

Results

The overlap group had significantly more incontinence symptoms after delivery and repair of the sphincter tear than before delivery (P < 0.0001); however, their incontinence symptoms were significantly fewer than those of the end-to-end group (P = 0.004). The prevalence of persistent rupture of the external anal sphincter was significantly lower in the overlap group (6/44, 13.6 percent) than in the end-to-end group (39/52, 75 percent; P < 0.0001). Internal anal sphincter rupture occurred in 5 patients (11.4 percent) in the overlap group and in 40 patients (76.9 percent) in the end-to-end group (P < 0.0001).

Conclusions

The overlap technique should be adopted as the method of choice for primary sphincter repair after obstetric tear.

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Acknowledgment

The authors thank Dr. Carol Norris for assistance.

Author information

Authors and Affiliations

  1. Department of Surgery, Helsinki University Central Hospital, PL 340, 00029 HUS, Helsinki, Finland

    A. Lepistö Ph.D., M.-L. Kylänpää Ph.D. & P. Luukkonen Ph.D.

  2. Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland

    T. Pinta Ph.D.

  3. Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland

    E. Halmesmäki Ph.D., T. Väyrynen M.D., A. Sariola M.D., V. Stefanovic Ph.D., A. Aitokallio-Tallberg Ph.D., V.-M. Ulander Ph.D. & P. Molander Ph.D.

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  1. A. Lepistö Ph.D.
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  2. T. Pinta Ph.D.
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  3. M.-L. Kylänpää Ph.D.
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  11. P. Luukkonen Ph.D.
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Correspondence to A. Lepistö Ph.D..

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Lepistö, A., Pinta, T., Kylänpää, ML. et al. Overlap Technique Improves Results of Primary Surgery after Obstetric Anal Sphincter Tear. Dis Colon Rectum 51, 421–425 (2008). https://doi.org/10.1007/s10350-007-9182-3

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  • DOI: https://doi.org/10.1007/s10350-007-9182-3

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