ArticleBMC women's health2020
Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery- a cross-sectional study in Norway.
Article in BMC women's health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 13 citations in OpenAlex.
- Bridging Gaps: Insights from a Rectal Buttonhole Tear Case Series.International urogynecology journal · 2026Article
- Impact of episiotomy on anal incontinence following second- to fourth-degree perineal tears-A cohort study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Detailed classification of second-degree perineal tears in the delivery ward: an inter-rater agreement study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Under-classified obstetric anal sphincter injuries.International urogynecology journal · 2022Article
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAim of the study was to estimate the prevalence of postpartum anal incontinence among women who delivered vaginally, and to assess the extent to which obstetric injuries to the anal sphincters are missed.
methodsAll women (both primiparous and multiparous) who delivered vaginally and received any kind of sutures in the perineal area at Innlandet Hospital Trust Elverum in Norway between January 1, 2015 and June 30, 2016 were invited to answer a questionnaire on St. Mark's incontinence score and to participate in a clinical examination of the pelvic floor including endoanal sonography.
resultsIn total 52,3% (n = 207) of the 396 invited women participated in the study. Mean St. Mark's score was 1.8 points (95% CI 1.4 to 2.1) at examination 14 months (mean) postpartum, and none of the participants suffered from weekly fecal leakage. Fecal urgency affected 11.7% (95% CI 7.1 to 16.3) of the participants, and 8.7% (95%CI 5.1 to 12.8) had weekly involuntary leakage of flatus. Nine women (9.3%, 95% CI 4.1 to 15.5) had a previously undetected third degree obstetric anal sphincter injury.
conclusionThe prevalence of anal incontinence among women who have delivered vaginally and received sutures due to 1st and 2nd degree perineal lacerations is low. Some obstetric anal sphincter injuries remain unrecognized at the time of delivery, but the symptoms of anal incontinence due to these injuries are in the lower half of the St. Mark's incontinence score. Women with persistent symptoms like fecal urgency or leakage of gas and/or feces should be referred to evaluation by a colorectal surgeon in order to achieve optimal treatment.
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