会阴切开术与产后大便失禁的关系

H. Khazraei, S. Hosseini, Mozhdeh Zamani, Ahmed Mohammed Ali Hussein Al-Hurry, M. Rahimi, L. Ghahramani, Fahime Hosseini
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摘要

背景:大便失禁是一个令人尴尬的问题,降低了妇女的生活质量。文献表明,妇女与产科创伤,特别是外阴切开术损伤肛门括约肌(内部和外部)。我们的目的是发现外阴切开术在妇女产后大便失禁中的作用。方法:对71例有阴道分娩史的女性进行肛管超声检查。FI程度采用Wexner失禁评分法测定。测量每位患者的会阴切开术次数。结果:尿失禁患者的平均Wexner评分为9.0±0.7。正常阴道分娩的平均值为3.48±0.3,有痔疮切除史的患者平均为33.8%。70%的患者在分娩过程中接受过一次或多次外阴切开术。结论:会阴切开术可能是尿失禁的危险因素之一,但我们没有发现会阴切开术与不会阴切开术患者的Wexner评分有显著差异。在一些危重病例的会阴切开术中,内镜超声是评估和预测肛门损伤的有效工具。
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Relationship between episiotomy and fecal incontinence after delivery
Background: Fecal incontinence is an embarrassing problem and decreases the woman’s quality of life. The literature has shown that women with obstetric trauma especially by episiotomy had damaged anal sphincter (Internal and External). We aimed to find the role of episiotomy in the fecal incontinence in women after delivery. Methods: In this study, 71 females with previous vaginal deliveries were investigated by endoanal ultrasonography. The degree of FI was measured using the incontinence score of Wexner. The number of episiotomies was measured for each patient. Results: The mean Wexner score was 9.0±0.7 in the incontinent patients. The mean of normal vaginal delivery was 3.48±0.3 and 33.8% of the patients whom had a history of hemorrhoidectomy. Of patients, 70% had undergone one or more prior episiotomies during their deliveries. Conclusion: Episiotomy could be one of the risk factors in fecal incontinence but we did not find any significant difference in Wexner score between patients with or without episiotomy. Endoanal sonography seems an effective tool to evaluate and prediction of anal injury during episiotomy in some critical cases.
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