All except Fitzpatrick and Garcia have reported the steps taken to minimise the selective reporting bias. Add to My Bibliography. Add to My Bibliography. They represent the technique used in these cases. Sphincter injury owing to fistula disease may result in poor outcome after repair. A randomised controlled trial comparing primary overlap with approximation repair of third-degree obstetric tears.
Methods of repair for obstetric anal sphincter injury
The gracilis muscle is shown ghosted underneath. A continuous non-locking method of repair with fast absorbing polyglactin sutures was used to repair the perineal muscles, vaginal epithelium and perineal skin. Fitzpatrick sub-divided perineal pain into perineal discomfort and need for perineal injection with local anaesthetic at three months. If the average treatment effect was not clinically meaningful, we would not combine trials. Different types of sutures used in 2 techniques overlap repair using polydiaxanone sutures and end-to-end repair using 0 Polyglycolic acid sutures.
Construction of Neoanus Gracilis Dynamic Anal Myoplasty
To benefit from pelvic muscle retraining, an individual must have some control over their pelvic floor muscles and must be willing to follow a prescribed exercise program. Patients were included in the study if they were aged 18 years or older, had an anatomic anal sphincter defect, and had an unsuccessful trial of pelvic floor physical therapy. More care was given to identify the inferior rectal branches of the pudental nerve traversing to the external sphincter posterolaterally. This operation is done when there is a tear to the anal sphincter muscle resulting in poor control of bowel motions. The continence function of the anal canal has been evaluated with FISI scoring reflecting both severity and frequency of the complaints
Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. The anatomy of the anal sphincter can be assessed by anal endosonography. There were considerable variations in outcome measures amongst the six included studies. Anal sphincter function after delivery: Fitzpatrick and Williams did not report the incidence of flatus incontinence, whereas Fernando reported the incidence of flatus incontinence at six weeks average RR 0. We have noted for each included study any important concerns we had about other possible sources of bias. Blinding of participants and personnel performance bias All outcomes Low risk All study investigators, including the statistician, were blind to the allocation code until the final analysis.