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Accuracy of clinical diagnosis of anal sphincter defect: clinical evaluation vs 3D- transperineal ultrasound (3D-TPUS)

Capanna, Federica; Haslinger, Christian; Wisser, Josef (2020). Accuracy of clinical diagnosis of anal sphincter defect: clinical evaluation vs 3D- transperineal ultrasound (3D-TPUS). Minerva Ginecologica, 72(4):187-194.

Abstract

BACKGROUND

Obstetric anal sphincter injuries (OASIS) are common and an important factor in the etiology of anal incontinence. The objective of this study was to evaluate, classify and compare the agreement of clinically diagnosed third-degree sphincter tears with 3D- transperineal ultrasound (3D-TPUS) realized within 3-7 days post-delivery.

METHODS

This is a retrospective observational study were 119 patients with third-degree obstetric anal sphincter tears were diagnosed and treated, 85 of those underwent a 3D-TPUS examination 3-7 days postpartum. We compared the proportion of third-degree perineal tears, classified with the clinical examination as Grade 3a+b and Grade 3c, with the 3D-TPUS.

RESULTS

In 16 patients with clinically diagnosed third-degree perineal tears Grade a and b, the ultrasound examination confirmed the lesion of the external anal sphincter (EAS) muscle, but in 9 patients (56% of the cases) we found a lesion of the internal anal sphincter (IAS) muscle, missed by clinical examination. In the remaining 69 patients with the third-degree perineal tears Grade c, the ultrasound examination confirmed both lesions (EAS and IAS muscles) in 56 women, but in 13 patients (19% of the cases) defects of the IAS muscle could not be confirmed by the ultrasound.

CONCLUSIONS

There was moderate agreement regarding diagnosis of perineal tears Grade 3a+b and Grade c between ultrasound and clinical examination, so a combined use of clinical and ultrasound knowledge can improve the possibility to find a gold standard in the diagnosis of OASIS.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Obstetrics and Gynecology
Language:English
Date:13 May 2020
Deposited On:10 Feb 2021 09:13
Last Modified:23 Oct 2024 01:40
Publisher:Edizioni Minerva Medica
ISSN:0026-4784
OA Status:Closed
Publisher DOI:https://doi.org/10.23736/S0026-4784.20.04562-1
PubMed ID:32403913
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