Margie Polden Memorial Lecture: Bridging the Gap between Obstetric and Colorectal Services for OASIS

Author(s): J. A. Cornish Department of Surgery, University Hospital of Wales, Cardiff, UK - Pages: 9-14

Abstract

Obstetric anal sphincter injuries (OASIS) associated with vaginal deliveries are the main cause of faecal incontinence (FI) in women. There has been a three-fold increase in OASIS in the past decade, and there is a higher incidence in first-time mothers. While it is possible that these injuries are becoming more common, it is more likely that detection is improving. Faecal incontinence has a two-stage presentation: although some women develop symptoms shortly after birth, most present during or after the menopause. Despite a range of effective therapeutic options, most people with FI do not seek care, and those who do often delay seeking treatment. Women should be reviewed in a perineal trauma clinic following the birth, and those who still have ongoing symptoms should have an endoanal ultrasound before being referred to relevant services. Physiotherapists are core members of the pelvic floor team, and it is vital that they receive FI training and education in order to improve the screening and management of this condition.

Keywords: colorectal surgery, faecal incontinence, multidisciplinary team, obstetric anal sphincter injuries, obstetric services.