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Frequency of Persistent Anal Symptoms After First Instrumental Delivery

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

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PURPOSE

This study was designed to evaluate persistent anal symptoms after first instrumental delivery beyond the postpartum period.

METHODS

This prospective study was performed in a cohort of primiparas who underwent instrumental delivery from January 1, 2001 to September 30, 2002. Questionnaires for anal symptoms were completed in the maternity ward on the day after delivery and by mail or telephone up to 12 months after the end of the inclusion period. Symptoms of fecal incontinence (solid and/or liquid stool) and precursor symptoms (flatus incontinence, soiling, and/or fecal urgency) were recorded.

RESULTS

Of the 212 females who completed the first questionnaire, 159 (75 percent) responded to the second. Overall, 8.8 percent of females had solid and/or liquid stool incontinence, 7.5 percent had involuntary flatus, 8.2 percent had symptoms of fecal urgency, and 24.5 percent experienced new anal symptoms, Of the five females with third-degree tears, none complained of anal incontinence. The only significant difference in delivery data between females who did and did not develop new anal symptoms was larger fetal head size in the new symptom group (96.4 vs. 93.9 mm, respectively; P < 0.05).

CONCLUSIONS

Frequency of new anal symptoms other than incontinence beyond postpartum period is underestimated in primiparas after instrumental delivery. Only fetal head size was found to predict occurrence of persistent anal incompetence after instrumental delivery.

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Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Marseille Public Hospital System (APHM), Marseille, France

    Chafika Mazouni M.D., Florence Bretelle M.D., Samy Battar M.D., Pascal Bonnier M.D. & Marc Gamerre M.D.

Authors
  1. Chafika Mazouni M.D.
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  2. Florence Bretelle M.D.
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  3. Samy Battar M.D.
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  4. Pascal Bonnier M.D.
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  5. Marc Gamerre M.D.
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APPENDIX

APPENDIX

The questionnaire that evaluates anal symptoms before and after delivery.

Name:

Date of birth:

Date of delivery:

Do you experience anal dysfunction before pregnancy or since your delivery?

1. Within the last year have you experienced involuntary loss of normal stools?

□ Yes

□ No

2. Within the last year have you experienced involuntary loss of intestinal gas?

□ Yes

□ No

3. Within the last year have you experienced fecal urgency (feeling that you must defecate immediately)?

□ Yes

□ No

4. Within the last year have you experienced constipation?

□Yes

□ No

5. Have you been pregnant since the first delivery?

□ Yes

□ No

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Cite this article

Mazouni, C., Bretelle, F., Battar, S. et al. Frequency of Persistent Anal Symptoms After First Instrumental Delivery. Dis Colon Rectum 48, 1432–1436 (2005). https://doi.org/10.1007/s10350-005-0050-8

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  • DOI: https://doi.org/10.1007/s10350-005-0050-8

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