Anal endosonographic findings in the follow-up of primarily sutured sphincteric ruptures
✍ Scribed by Dr M. B. Nielsen; C. Hauge; O. Ø. Rasmussen; J. F. Pedersen; J. Christiansen
- Publisher
- John Wiley and Sons
- Year
- 1992
- Tongue
- English
- Weight
- 353 KB
- Volume
- 79
- Category
- Article
- ISSN
- 0007-1323
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✦ Synopsis
Twenty-four women with primary suture of an obstetric tear of the anal sphincter were examined with anal endosonography a median of 12 (range 3-18) months after delivery. Endosonography was normal in ten patients, of whom one was incontinent. The examination showed a defect in the external anal sphincter in 13 patients; six of these were incontinent, two of whom had normaljndings on palpation. An isolated internal sphincter defect was found in a continent patient. Since anal endosonography causes no more discomfort than digital examination, it may be useful to identify patients who would benefit from surgical reconstruction of the anal sphincter.
Obstetric tears and rupture of the anal sphincters may result in anal incontinence despite primary repair. Anal manometry is used to evaluate the function of the anal sphincter, but its results may be poorly correlated to the presence or absence of anal incontinence in these patients'. If manometry shows low values after childbirth, restoration to normal values should indicate that recovery of the anal sphincter is complete, but this is not always the case'.'.
The internal and external anal sphincters can be visualized with anal e n d o ~o n o g r a p h y ~? ~, which has been used to demonstrate sphincteric defects in incontinent patients5v6. The aim of this study was to determine whether anal endosonography could visualize any sphincteric abnormalities in patients after primary repair of anal sphincter rupture and to identify by means of anal endosonography patients who might benefit from surgical reconstruction of the anal sphincter.