Clinical Outcome of Surgical Treatment in Patients with Obstetric Injury

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  • 陳旧性会陰裂傷に対する修復術の検討

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We evaluated the clinical outcome of surgical repair in 15 patients with obstetric injury. The patients had injuries at a mean age of 24.9 years old, and underwent surgery at mean 47.3 years old. Two patients suffered from fecal incontinence (FI) alone, 4 from rectovaginal fistula (RF) alone, 5 from FI and RF, and 4 from cloaca-like deformity. The surgical procedures consisted of perineoplasty with “-” or “X”-shaped incision, anterior levatoplasty and plication of injured external anal sphincter. Nine of 11 FI patients did not complain of symptoms after surgery. Two patients had surgical site infection, and 2 other patients had wound dehiscence. Manometric data revealed that maximum anal resting pressure increased (preoperative: 25.9±10.0 mmHg, postoperative” 34.9±15.7 mmHg: p=0.021), but squeeze pressure and rectal sensation did not change. In defecography, RF and rectocele disappeared after surgery. Our surgical procedure may be appropriate for severe obstetric injury.

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