Residents' Papers GynecologyFrequency and predictors for postpartum fecal incontinence☆,☆☆
Section snippets
Material and methods
A 1-page self-administered questionnaire was completed by women seen in the Oregon Health and Sciences University hospital (OHSU) outpatient clinics for the 6-week postpartum visit. Fifty-two women were approached to participate, and 50 women chose to participate. The study was approved by the OHSU institutional review board.
The survey, available in English and Spanish, contained 30 questions about delivery events, fecal incontinence symptoms, and patient characteristics. Questions about
Results
Among the 50 participants, the average age was 27 years (range 18-40 years), median parity was 1 (range 1-4), and median postpartum status was 6 weeks (range 2-16 weeks). Thirty-seven of the 50 women (74%) had vaginal deliveries, 3 (6%) had operative deliveries, and 10 (20%) had cesarean deliveries (2 without labor, 7 with labor but no pushing, 1 after labor and pushing). Twenty-eight of 48 women (58%) reported a perineal laceration requiring repair, specifically 3 (16%) reported a laceration
Comment
The frequency of fecal incontinence was 38% in the postpartum period. This frequency is higher than what has been reported in previous studies4, 5, 6, 7, 8 and may reflect the inclusion of incontinence of flatus, one-time instances, and events that are exclusively related to intercourse. It is important to consider each of these items as all may have profound impact for patients.
As shown in other studies, a perineal laceration of any type was the most significant delivery event associated with
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Cited by (53)
Anal incontinence and obstetrical anal sphincter injuries, epidemiology and prevention
2018, Gynecologie Obstetrique Fertilite et SenologieInternal anal sphincter: Clinical perspective
2017, SurgeonCitation Excerpt :Obstetric anal sphincter injuries during childbirth have long been recognised as a leading cause of faecal incontinence. About 13–25% of women report some form of anal incontinence three to six month after vaginal or caesarean delivery24,25 with the prevalence falling to 1–6% by 12 months.26,27 Patients can suffer a range of symptoms including flatus incontinence, passive soiling, or frank incontinence of stools.
Management of postpartum anal incontinence: A systematic review
2015, Progres en UrologieSphincter Disturbances
2014, Encyclopedia of the Neurological SciencesCharacterization of colorectal symptoms in women with vesicovaginal fistulas
2012, International Journal of Gynecology and ObstetricsCitation Excerpt :The prevalence of FI symptoms in this group of patients is lower than expected given the extensive damage to their anterior pelvis from prolonged obstructed labor. The prevalence of FI and AI in postpartum women in the USA ranges from 10%–18% and 24%–29%, respectively [14–16]. Thus the prevalence of symptoms in women with VVF is lower than rates reported in the USA where prolonged labor and VVF are much less common.
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Supported by National Institutes of Health, National Institute for Child Health and Development grant No. 5R01HD41139-02.
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Reprints not available from the authors.