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Anorectal symptoms after various modes of vaginal delivery

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Abstract

The aim of this study was to determine the prevalence of, and the changes in, anorectal symptoms following different modes of vaginal delivery in primiparous women. Six hundred and seventeen questionnaires were distributed to primiparous women 3–4 years after delivery. The questionnaires were designed to obtain information regarding the development of anorectal symptoms, including the type of symptoms experienced, their severity and their impact on lifestyle. A total of 479 questionnaires were returned, representing a response rate of 77.6%. Women included in the study were divided into three groups on the basis of the mode of delivery (normal vaginal, vacuum extraction and forceps). Any episode of fecal incontinence was considered to be abnormal. Following delivery, de novo incontinence developed in 22%. There was no significant difference between the three modes of vaginal delivery in terms of the development of fecal incontinence (normal vaginal delivery 22%, vacuum extraction 20%, forceps delivery 26%). Furthermore, analysis of obstetric variables could not identify one significant independent risk factor for anorectal incontinence. The results of this study suggest that instrumental vaginal deliveries are as safe as a normal vaginal delivery in terms of the development of anorectal symptoms.

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Abbreviations

PNTML:

Pudendal nerve terminal motor latencies

EMG:

Electromyography

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Acknowledgements

We wish to thank Dr. R. Euser (clinical data), Dr. H.J.A. Wijnne (statistical analysis, Department of Epidemiology, University of Utrecht ) and Mrs. Y. Farinazo-van der Put for assisting in the preparation of this study.

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Authors and Affiliations

  1. Department of Gynecology, Meander Medical Center, Ringweg Randenbroek 110, 3816 CP, Amersfoort, The Netherlands

    S. E. Schraffordt Koops

  2. Department of Gynecology, St. Elisabeth Hospital, Tilburg, The Netherlands

    H. A. M. Vervest

  3. Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands

    H. J. M. Oostvogel

Authors
  1. S. E. Schraffordt Koops
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  2. H. A. M. Vervest
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  3. H. J. M. Oostvogel
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Corresponding author

Correspondence to S. E. Schraffordt Koops.

Additional information

Editorial Comment: This is a well-written article that addresses an important issue in obstetrics and gynecology, i.e. the likely consequences of defective anal sphincter function after pregnancy and delivery. As the authors emphasize, the article suffers from the fact that this was a retrospective study. Furthermore, it would have been very interesting to know the differences between patients undergoing cesarean section and those giving birth vaginally. In two recently published investigations there were no differences between cesarean section and normal vaginal delivery in terms of fecal and urinary incontinence post partum. We still do not know how to identify patients who are at risk of developing incontinence after pregnancy and delivery.

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Schraffordt Koops, S.E., Vervest, H.A.M. & Oostvogel, H.J.M. Anorectal symptoms after various modes of vaginal delivery. Int Urogynecol J 14, 244–249 (2003). https://doi.org/10.1007/s00192-003-1040-9

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  • DOI: https://doi.org/10.1007/s00192-003-1040-9

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