Obstetric anal sphincter injuries: an underestimated condition
The identification and assessment of anal sphincter lesions following obstetric injuries is often inaccurate due to inadequate diagnostic procedures.
However, an accurate diagnosis of post-delivery sphincter lesions is fundamental to prevent or reduce the risk of bowel incontinence.
Birth trauma and subsequent obstetric anal sphincter injuries are in fact the main risk factor for fecal incontinence in women.
Obstetric perineal lacerations: the importance of early diagnosis
For this reason, the early diagnosis of possible post-delivery perineal lacerations is crucial in preventing or reducing the risk of anal continence disorders.
This assessment should be carried out thoroughly and fully between 1 and 6 months after delivery.
Any vaginal birth can in fact cause occult anal sphincter lesions that can only be identified and correctly diagnosed by means of specific instrumental examinations.
These examinations must include a complete assessment of sphincter damage from both a functional and morphological point of view.
Functional diagnosis of obstetric anal sphincter injuries: Anorectal Manometry
Anorectal manometry is an essential examination for the assessment of anal sphincters functions.
By means of this exam, it is possible to identify disorders of the sphincter system during both sphincter con-traction and relaxation phase. It is also possible to assess rectal sensitivity and sphincter muscle contraction reflexes.
Anorectal manometry can therefore:
- show functional disorders of the sphincter complex.
- identify damage to the internal and external anal sphincters.
- monitor biofeedback results.
- show the absence of contractile reflexes.
- plan the management of the patient after anal sphincter injuries.
For these reasons, anorectal manometry is a fundamental examination in all clinically evident or suspected cases of anal incontinence.
THD® Anopress is a cutting-edge portable solution for clinical anorectal manometry which overcomes many of the limitations associated with traditional anal manometry. To find out more, click here.
Morphological evaluation of perineal lacerations from childbirth: Endoanal Ultrasonography (EAUS)
Endoanal ultrasonography (EAUS) allow to assess the morphology of the sphincter complex and determine the presence and extent of any sphincter le-sions.
The EAUS exam is the gold standard for the assessment of anal sphincter anato-my and, together with anorectal manometry, is fundamental for the precise diagnosis of obstetric anal sphincter lesions.
Transanal ultrasonography allows the specialist to view the pelvic floor and sphincter muscles and identify the fol-lowing obstetric lesions:
- lacerations of the external anal sphincter
- lacerations of the internal anal sphincter
During the injuries assessment, EAUS allows to identify the length and depth of the muscle involved, making the diagnosis even more accurate.
THD® EAUS Probe ultrasound probe allows to assess pelvic floor and sphincter muscles, enabling anatomical and, together with anal manometry, functional evaluations, essential for treating obstetric anal sphincter injuries. To find out more, click here.
THD® EAUS Probe is used in combination with THD® Procto Software on two different platforms: THD® HRStation and THD® ProctoMobile.
THD® Procto Software is a CE-marked medical device certified by TUV Rheinland.
THD® ProctoMobile: the all-in-one portable diagnostic system for the diagnosis of obstetric anal sphincter injuries.
THD® ProctoMobile is the integrated, portable diagnostic system that allows performing anorectal manometry and 360° EAUS conveniently and quickly with a single instrument.
Its compact size allows both examinations to be carried out in smaller practices or at the patient’s home. THD® ProctoMobile is ready to use.
This innovative portable diagnostic system also allows the specialist to carry out diagnosis and interpretation of the data immediately after the examination.
To find out more advantages of THD® ProctoMobile, click here.