Evidence map›Paper›PMID 32556846›Full record

ArticleInternational urogynecology journal2020

Outcome of anal symptoms and anorectal function following two obstetric anal sphincter injuries (OASIS)-a nested case-controlled study.

Nicola Adanna Okeahialam, Ranee Thakar, Madhu Naidu, Abdul H Sultan

Open access · hybridAbstract read
In one paragraph

Article in International urogynecology journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Highlights of the 40th IUGA meeting in Nice, June 2015.International urogynecology journal · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Nicola Adanna OkeahialamUrogynaecology Clinical Research Fellow, Croydon University Hospital, Croydon, UK.
Ranee ThakarCroydon University Hospital, 530 London Rd, Thornton Heath, CR7 7YE, UK.
Madhu NaiduGynaaecare, Marathahalli, Bengaluru, India.
Abdul H SultanCroydon University Hospital, 530 London Rd, Thornton Heath, CR7 7YE, UK. abdulsultan@nhs.net.ORCID http://orcid.org/0000-0001-8979-2304
Croydon University Hospital · GBSt George's, University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisObstetric anal sphincter injury (OASI) is a significant risk factor for developing anal incontinence. It can therefore be hypothesised that recurrent OASI in a subsequent delivery may predispose women to further anal sphincter dysfunction.

methodsA nested case-controlled study based on data collected prospectively between 2006 and 2019. Women matched for age and ethnicity, with a history of one OASI and no sphincter damage in a subsequent delivery (control) were compared to women sustaining a second OASI. Assessment was carried out using the St Mark's score (SMIS), anorectal manometry and endoanal ultrasound scan (findings quantified using the modified Starck score).

resultsEighty-four women were included and equally distributed between the two groups, who were followed up 12 weeks postnatally. No difference in SMIS scores was found. Maximum resting pressure (MRP, mmHg) and maximum squeeze pressure (MSP, mmHg) were significantly reduced in the study group. Median (IQR) MRP in the study group was 40.0 (31.3-54.0) versus 46.0 (39.3-61.5) in the control group (p = 0.030). Median (IQR) MSP was 73.0 (58.3-93.5) in the study group versus 92.5 (70.5-110.8) (p = 0.006) in the control group. A significant difference (p = 0.002) was found in the modified Starck score between the study group (median 0.0 [IQR 0.0-6.0]) and control group (median 0.0 [IQR 0.0-0.0]).

conclusionsWe have demonstrated that women with recurrent OASI do not have significant anorectal symptoms compared to those with one OASI 12 weeks after delivery, but worse anal sphincter function and integrity. Therefore, on long-term follow-up, symptoms may possibly develop. This information will be useful when counselling women in a subsequent pregnancy.

Indexed as

Anal CanalFecal IncontinenceCase-Control StudiesDelivery, ObstetricFemaleHumansPregnancyUltrasonographyAnal incontinenceAnorectal manometryEndoanal ultrasoundObstetric anal sphincter injuriesPerineal traumaRecurrent obstetric anal sphincter injury

Identifiers

PMID32556846
PMCPMC7561534
OpenAlexW3036658710

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LicenceCC BY
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Registered trials

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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.