Margie Polden Memorial Lecture: The perineal clinic – the management of women following obstetric anal sphincter injury

Author(s): G. Fowler - Pages: 6 -11

Abstract

Obstetric anal sphincter injury (OASIS) is diagnosed after vaginal childbirth in 2–10% of women. Despite there being multiple recognized risk factors, there is no reliable method to either predict or prevent OASIS. An OASIS is a tear involving the anal sphincter complex, and is the leading cause of faecal incontinence (FI) in women. Diagnosis at the time of delivery, followed by immediate repair in theatre by experienced surgeons, are key to preventing the symptoms of FI in the long-term.
Obstetric anal sphincter injury is also associated with perineal pain, sexual dysfunction and psychological sequelae, all of which may have a significant impact on women’s quality of life, including the ability to bond with their new-born
baby. Liverpool Women’s Hospital has a dedicated perineal clinic that follows up women
who have suffered an OASIS. The aim of this paper is to outline the clinic’s approach
to patient care and the management of the problems faced by these women,
including the mode of delivery in any future pregnancy.
Keywords: management, obstetric anal sphincter injury, perineal clinic.