ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2025
Comparison of obstetric and non-obstetric anal sphincter injuries: Surgical outcomes and Jorge Wexner score analysis.
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to compare the long-term continence outcomes of patients who underwent surgical repair for obstetric anal sphincter injuries (OASIS) and non-OASIS, based on the Jorge Wexner score. Additionally, predictive factors associated with complete continence restoration versus persistent fecal incontinence were analyzed.
methodsA retrospective analysis was conducted on 13 patients treated surgically for anal sphincter injuries at Erciyes University Faculty of Medicine between 2016 and 2019, with a minimum follow-up duration of five years. Patients were categorized into obstetric (n=8) and non-obstetric (n=5) groups. Functional outcomes were assessed using the Jorge Wexner score at 6 months, 1 year, and 5 years postoperatively. Continuous variables were analyzed using the Mann-Whitney U test, categorical variables with Fisher's exact test, longitudinal changes with the Friedman test, and potential predictors of full continence were assessed via binary logistic regression.
resultsThe non-OASIS group exhibited significantly higher mean age (p=0.045) and longer hospital stays (p=0.006) compared to the obstetric group. Perineal examination revealed more extensive tissue loss and contamination in non-OASIS cases, often requiring fecal diversion, whereas obstetric injuries were typically cleaner and linear in nature. Although higher Wexner scores were observed in the non-OASIS group at all time points, between-group differences were not statistically significant. Wexner scores varied significantly over time within the non-OASIS group (p=0.014) but not within the obstetric group (p=0.257). No individual factor showed a significant association with complete continence restoration. The logistic regression model was statistically significant overall (p=0.027), though none of the independent predictors reached significance.
conclusionCompared with obstetric injuries, non-OASIS cases tend to involve a more prolonged recovery course and longer hospitalization. These findings suggest a more complex clinical trajectory in non-OASIS patients.
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