Research

Does perineal body thickness affect fecal incontinence in multiparous patients?

Ahmed Mohammed Ali Hussein Al Hurry, Abdulrazzak kalaf Hassan, Seyed Vahid Hosseini, Hajar Khazraei, Mohammed Abdzaid Akool, Lale Moosavi, Saeedeh Pourahmad

Abstract


Background:

Obstetric trauma is the mostcommon cause of fecal incontinence in multiparous women.The literature has shown that women with obstetric trauma to the anal sphincter have decreased perineal body thickness (PBT).We aimed to analyze the role of PBT by endoanalultrasonographyinassessment of this type of fecal incontinence in multiparous patients.

Methods:

Forty-fourfemales with anal incontinence and 36 asymptomatic ones that had two or more previous deliveries were investigated with endoanalultrasonographyfrom January2016 to December 2016. All patients were divided into three groups on thebasis of PBT: 10 mm or less, 10 to 12 mm, more than12 mm. The degree of FI was measured using the incontinence score of Wexner. Sphincter angle defect was separately measured for each patient.

Results:

The mean age of all our 80 patients was 46.9±1.3 years (26–77 years) and the mean PBT in incontinent patients was 8.78 ± 2.84 mm and 12.65± 16.76mm in asymptomatic subjects (P < 0.001). The mean Wexner score was 8.6 (2-20 in incontinent patients). External sphincter defect angles were negatively correlated with PBT (p = 0.045).For 89% of the patients there was a history of vaginal delivery and 62.5% had undergone one or more prior episiotomies during delivery.

Conclusion:

A PBT less than 10 mm is associated with sphincter defect in most incontinent patients. Perineal body thickness plays such a significantly important role in fecal incontinence that it should be one of the factors involved in anal incontinency evaluations.

 


Authors' affiliations

Ahmed Mohammed Ali Hussein Al Hurry, Department of General Surgery, Al Hussein Teaching Hospital, Kerbala, Iraq

Abdulrazzak kalaf Hassan, Department of Surgery, Medical College, Kerbala university, Kerbala, Iraq

Seyed Vahid Hosseini, Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Hajar Khazraei, Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Mohammed Abdzaid Akool, Department of Surgery, Medical College, Jabir Ibnhayan medical university, Najaf, Iraq

Lale Moosavi, Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Saeedeh Pourahmad, Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran

Full Text

PDF (151KB)

Keywords

Perineal body thickness; Anal ultrasonograph; Fecal incontinence; Sphincter defect

Cite this article

South African Journal of Obstetrics and Gynaecology 2018;24(3):. DOI:10.7196/sajog.1305

Article History

Date submitted: 2018-01-15
Date published: 2019-02-22

Article Views

Abstract views: 372
Full text views: 130

Comments on this article

*Read our policy for posting comments here