Surgical Treatment Results in Obstetric and Iatrogenic Anal Sphincter Injuries

One of the most important causes of perineal tears is vaginal delivery or episiotomy. It is also among the iatrogenic causes. Perineal tears have the advantage that they can be effectively corrected by surgical repair. However, if perineal tears occurring upon delivery are not recognized and repaired immediately, the possibility of developing fecal incontinence and other complications increases. Since the aim of our study was to examine the surgical treatment of obstetric perineal tears, the files of patients who underwent anal sphincter repair between January 1, 2017, and January 1, 2019, were reviewed retrospectively. The files of 26 patients were analyzed in the present study. Sixteen patients were due to obstetric injuries; fourteen (70%) patients in the first 24 hours, and 6 (30%) occurred later. The data of the group repaired in the first 24 hours (early group) and the group repaired later was analyzed; there was no significant difference in terms of mean age, the number of births, and episiotomy opening (p>0.05674). However, there was a significant difference in the hospital stay (p<0.05). Obstetric anal sphincter injuries affect about half of women who have a vaginal delivery, and incontinence develops in 25% of primiparous patients with these injuries. The opinion of an experienced second physician is required. Effective sphincter repairs applied in this way can prevent long-term complications such as anal incontinence.

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