Physiotherapy service provision and its effectiveness after obstetric anal sphincter injuries

Author(s): F. Healy, E. Barry & S. O’Sullivan - Pages: 30–41

Abstract

There is limited evidence of the effectiveness of physiotherapy after obstetric anal sphincter injuries (OASIS). The primary objective of this study was to determine if there is a role for physiotherapy intervention after OASIS. A follow-up postal questionnaire was sent out 1–2 years postpartum to 100 women who had sustained OASIS in 2010. The questionnaire included the short form of the Pelvic Floor Distress Inventory (PFDI-20). The patients had previously been screened by a physiotherapist by telephone at 6 weeks postpartum to identify any who were symptomatic. Those women who reported symptoms received a course of physiotherapy. The postal questionnaire achieved a response rate of 60%. Women who reported symptoms at the 6-week telephone call and attended their physiotherapy appointments were significantly less symptomatic in terms of their scores on the PFDI-20 than those who did not attend (P = 0.005). Women who reported no symptoms at the 6-week telephone phone call and were not later referred from the perineal clinic had low PFDI-20 scores at 1–2 years post-partum. A course of physiotherapy appears to benefit women who report symptoms of pelvic floor dysfunction (PFD) after OASIS. Further investigation is recommended in order to establish why women do not attend physiotherapy even though they are experiencing
PFD.

Keywords: incontinence, obstetric anal sphincter injuries, pelvic floor dysfunction, physiotherapy, service provision.