Quality of life and 3D-EUS assessment for anal incontinence after childbirth

  1. Patricia Tejedor 1
  2. Ignacio Bodega Quiroga 2
  3. Javier Plaza Arranz 1
  4. Mario Ortega Lopez 1
  5. Carlos Gutiérrez Ortega 2
  6. Damián García Olmo 1
  7. Carlos Pastor Idoate 1
  1. 1 Hospital Universitario Fundación Jiménez Díaz. Madrid, Spain
  2. 2 Hospital Universitario Gómez Ulla. Madrid, Spain
Revista:
Revista Española de Enfermedades Digestivas

ISSN: 2340-416 1130-0108

Año de publicación: 2019

Volumen: 111

Número: 6

Páginas: 453-459

Tipo: Artículo

DOI: 10.17235/REED.2019.6040/2018 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Revista Española de Enfermedades Digestivas

Objetivos de desarrollo sostenible

Resumen

Background: the incidence of obstetric sphincter tears has risen to 15-30% and the prevalence of anal incontinence (AI) symptoms after childbirth may be as high as 40%. The present study evaluates the correlation between obstetric injuries detected by endoanal ultrasound (3D-EUS) and AI symptoms, as well as their impact on the quality of life (QOL) of women after childbirth. Methods: a prospective observational study was performed of pregnant women evaluated before (baseline) and three months after childbirth to ensure the integrity of the anal sphincters and to evaluate possible injuries. The Fecal Incontinence Quality of Life (FIQL) questionnaire and the Cleveland Clinic Score of Incontinence (Wexner) were completed before and after childbirth. The questionnaire results were correlated with an assessment of sphincter defects performed by 3D-EUS. Results: a total of 56 females were included in the study. Overall, 48% developed symptoms of AI after childbirth, with a significant decrease in their FIQL compared to the initial evaluation, 3.9 (0.05) vs 3.4 (0.8), respectively (p = 0.000). In addition, 42% of the cohort presented with some kind of obstetric sphincter defect on the 3D-EUS. Instrumental assisted delivery and the sphincter defects were the only two significant factors identified via multivariate analysis that were associated with a decrease in QOL (0.4, 95% CI, 0.07-0.8). Conclusions: AI after childbirth was associated with a huge impact on QOL, especially in patients with sphincter injuries. A complete clinical evaluation, including 3D-EUS, is recommended to prevent, manage or treat AI in primiparous females.