Photo Credit: Nadzeya Haroshka

The following is a summary of “Management after obstetric anal sphincter injury: anorectal manometry and symptoms predict long-term fecal incontinence,” published in the September 2024 issue of Gastroenterology by Trieu et al.

Obstetric anal sphincter injury (OASI) can lead to significant problems, but it’s uncertain if anorectal manometry (ARM) helps choose the proper treatment.

Researchers conducted a retrospective study to assess the role of ARM and symptom evaluation after OASI in predicting long-term anal incontinence.

They analyzed 205 consecutive women post-OASI who had baseline ARM and symptom assessments; 99 were followed up long-term with a median of 6.6 years. Associations between post-OASI ARM testing and anal incontinence were investigated in both the short and long term, alongside clinical factors related to obstetrics. 

The results showed 4th-degree tears and reduced anal resting and squeeze pressures associated with short-term anal incontinence. Women with anal incontinence at baseline and individuals with lower anal resting pressure were at higher risk for long-term fecal incontinence (FI). Threshold reporting FI during long-term follow-up was effectively predicted by a baseline anal resting pressure of 59 mmHg, with no short-term asymptomatic women above the threshold reporting FI in the long term.

Investigators concluded the presence of anal incontinence and ARM symptoms, and post-OASI were both predictive of subsequent long-term FI, with a best-fit cut-off of 59 mmHg for anal resting pressure.

Source: journals.lww.com/ajg/abstract/9900/management_after_obstetric_anal_sphincter_injury_.1325.aspx