Outcomes of surgical treatment in women with anal incontinence secondary to trauma of delivery

Abstract

Objectives: Anal incontinence is the involuntary loss of flatus and feces and often occurs, as a reason of trauma due to the vaginal delivery in women. In this study, we aimed to evaluate the results of the patients, who under­went surgery, with anal incontinence due to the vaginal delivery. Materials and methods: Between January 2005 and De­cember 2010, 15 patients, who had anal incontinence due to the vaginal delivery and underwent overlapping sphinc­teroplasty, were analyzed retrospectively. Results: The mean age was 34.7 (range 18-49) years. Sphincter injuries were grade 4 in all patients. The time for the surgery after the formation of vaginal tear varies between the first day after injury and 17 years. Wound infection developed in 2 of the patients. Anal incontinence was revealed in 4 patients in the postoperative period, 3 of them had incontinence of the flatus and 1 of them had flatal and fecal incontinence. Total continence was achieved in 11 patients. Conclusion: The sphincter injuries due to the vaginal delivery traumas can be easily defined with a detailed physical examination and careful questioning of the medi­cal history. Satisfactory results can be achieved with the surgical treatment.

Keywords

• Anal incontinence, vaginal delivery, overlap­ping sphincteroplasty.

Doğum travması sonucu anal inkontinans gelişen kadınlarda cerrahi tedavi sonuçları

Abstract

Amaç: Anal inkontinans, gaz ve dışkının istem dışı kaçı­rılmasıdır ve kadınlarda sıklıkla vajinal doğum esnasında gerçekleşen travmaya bağlı ortaya çıkar. Bu çalışmada vajinal doğum travmasına bağlı anal inkontinans gelişen ve cerrahi uyguladığımız hastaların sonuçlarının değer­lendirilmesi amaçlandı. Gereç ve yöntem: Ocak 2005-Aralık 2010 yılları arasın­da vajinal doğum travmasına bağlı anal inkontinans nede­niyle overlapping sfinkter onarımı uygulanan 15 hastanın dosyaları retrospektif olarak incelendi. Bulgular: Hastaların ortalama yaşı 34.7±9.2(18-49) yıl idi. Sfinkter hasarı hastaların tamamında evre 4 idi. Yırtı­ğın oluşması ile ameliyata kadar geçen süre, hasar son­rası ilk gün ile 17 yıl arasında değişmekteydi. Postoperatif dönemde hastaların 2\'sinde yara yeri enfeksiyonu, 1\'inde gaz-gaita inkontinansı, 3\'ünde gaz inkontinansı gelişti. 11 hastada kontinans sağlandı. Sonuç: Vajinal doğum travmalarına bağlı sfinkter hasar­ları ayrıntılı fizik muayene ve dikkatli bir sorgulama ile kolaylıkla tanımlanabilir. Cerrahi tedavi ile memnuniyet verici sonuçlar elde edilebilmektedir.

Keywords

• Anal inkontinans, vajinal doğum, overlapping sfinkter onarım

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