ArticleInternational urogynecology journal2018
Effect of subsequent vaginal delivery on bowel symptoms and anorectal function in women who sustained a previous obstetric anal sphincter injury.
Article in International urogynecology journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta-analysis.BJOG : an international journal of obstetrics and gynaecology · 2025Pooled it
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Mode of Subsequent Delivery After Obstetric Anal Sphincter Injuries (OASIs).International urogynecology journal · 2026Review
- Rectal buttonhole tear during parturition: A case report and literature review.BMC pregnancy and childbirth · 2026Review
- The Japan Society of Coloproctology Practice Guidelines for Fecal Incontinence 2024 (Revised Second Edition).Journal of the anus, rectum and colon · 2026Review
- Clinical Grade of Obstetric Anal Sphincter Injuries and Prediction of Mode of Birth Recommendations: A 20-Year Retrospective Analysis.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Association of delivery mode and number of pregnancies with anorectal manometry data in patients with postpartum constipation.BMC pregnancy and childbirth · 2023Article
- Risk Factors for Anal Continence Impairment Following a Second Delivery after a First Traumatic Delivery: A Prospective Cohort Study.Journal of clinical medicine · 2023Article
- Mode of delivery following obstetric anal sphincter injury: a 7-year retrospective review and follow-up cohort survey.International urogynecology journal · 2022Article
- Comparison of diagnostic criteria for significant anal sphincter defects between endoanal and transperineal ultrasound.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2022Article
- Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury.International urogynecology journal · 2022Article
- Berlin survey on obstetric anal sphincter injury (OASI).Archives of gynecology and obstetrics · 2022Article
- Faecal incontinence in adults.Nature reviews. Disease primers · 2022Review
- Three-Dimensional Ultrasound Imaging under Optimized Nuclear Regression Reconstruction Algorithm in the Diagnosis Vaginal Delivery and Cesarean Section on the Anal Sphincter Complex of Primiparas.Computational and mathematical methods in medicine · 2022Article
- Early secondary repair of obstetric anal sphincter injuries (OASIs): experience and a review of the literature.International urogynecology journal · 2021Review
- Effect of a subsequent pregnancy on anal sphincter integrity and function after obstetric anal sphincter injury (OASI).International urogynecology journal · 2021Observational
- Isolated rectal buttonhole tears in obstetrics: case series and review of the literature.International urogynecology journal · 2021Review
- Establishing a peripartum perineal trauma clinic: a narrative review.International urogynecology journal · 2021Review
- The impact of mode of subsequent birth after obstetric anal sphincter injury on bowel function and related quality of life: a cohort study.International urogynecology journal · 2020Observational
- A one-stop perineal clinic: our eleven-year experience.International urogynecology journal · 2020Observational
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisOur primary objective was to prospectively evaluate anorectal symptoms, anal manometry and endoanal ultrasound (EAUS) in women who followed the recommended mode of subsequent delivery following index obstetric anal sphincter injuries (OASIs) using our unit's standardised protocol. Our secondary objectives were to evaluate the role of internal anal sphincter defects and also to compare outcomes in a subgroup of symptomatic women with normal anorectal physiology.
methodsThis is a prospective follow-up study of pregnant women with previous OASIs who were counselled regarding subsequent mode of delivery between January 2003 and December 2014. Assessment involved the St Mark's Incontinence Score (SMIS), anal manometry and EAUS at both antepartum and 3-month postpartum visits. Data were analysed using Wilcoxon and Mann-Whitney U tests.
resultsThree hundred and fifty women attended the perineal clinic over the study period, of whom 122 met the inclusion criteria (99 vaginal delivery [VD], 23 caesarean section). No significant worsening of anorectal symptoms was observed following subsequent delivery in the VD group (p = 0.896), although a reduced squeeze pressure was observed at 3 months postpartum (p < 0.001). There were no new defects on EAUS in either group.
conclusionsThis study showed no significant worsening of bowel symptoms and sphincter integrity apart from lower squeeze pressures at 3 months postpartum in the VD group when our standardised protocol was used to recommend subsequent mode of delivery. In the absence of a randomised study, use of this protocol can aid clinicians in their decision-making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.