Decades-long suffering from obstetric injuries

Date:
February 23, 2023
Source:
University of Gothenburg
Summary:
Bowel leakage, the need for anal incontinence protection and a
restricted social life may cause severe, decades-long suffering
among women with obstetric injuries to the anal opening, according
to a new study.


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FULL STORY ========================================================================== Bowel leakage, the need for anal incontinence protection and a restricted social life may cause severe, decades-long suffering among women with
obstetric injuries to the anal opening, according to a study from the University of Gothenburg.


==========================================================================
The study, published in the American Journal of Obstetrics and Gynecology, comprises a total of more than 11,000 women who had given birth vaginally
in Sweden, twice, in the years 1987-2000.

The researchers have previously described how the risk of accidental
bowel leakage increases after obstetric anal sphincter injuries (OASIs)
during childbirth. The present study focuses on the severity of these
problems and their potential impact on women's lives two decades later.

Three groups were studied: women who had no anal sphincter injuries,
those who incurred the OASI during one of the births, and those with an
OASI both times they gave birth. The data analysed came from the Swedish National Birth Register and replies to a questionnaire concerning the
women's symptoms of bowel leakage and the psychological impact and effect
on social life of the incontinence after 20 years.

Problems increase with number of injuries Of the women with two OASIs,
10.5 percent report leakage of liquid feces two times or more monthly;
this is categorized in the study as high-frequency anal incontinence. When
the women with low-frequency incontinence are included as well, the
proportion is 34.9 percent. Of all the women with two injuries, 29.6
percent state that leakage affects their everyday life.

The results thereafter follow a descending scale. Of the women with one
anal sphincter injury, 6.4 percent report high-frequency leakage and 21.7 percent leakage of both high and low frequency. For 19.7 percent of the
latter, the injury affects their everyday life. Of the women with no OASI,
2.7 percent report high-frequency leakage and 10.8 percent either high-
or low-frequency leakage, while 8.6 percent report that the incontinence impacts everyday life.

In terms of the severity of these problems, going from no injury to one
injury is roughly equivalent to the step from one to two injuries. Thus,
the problems are cumulative, and this is also reflected in the women's subjective perception of how their everyday lives are affected by fecal incontinence.

Incontinence pads for fecal leakage are used by 2.3 percent of the
women with no OASI, 7.1 percent of those with one OASI and 8.4 percent
of those with two OASIs. The study found no influence of OASIs on other
pelvic floor disorders or symptoms in the lower urinary tract.

Major impact on quality of life Attitudes vary, too. In women with no
OASI, fecal incontinence is found "bothersome" by 28.2 percent. The corresponding share in the group with one injury is 43.9 percent,
against 46.0 percent among those with two injuries.

The first and corresponding author of the study is Ida Nilsson, a
researcher affiliated with Sahlgrenska Academy, University of Gothenburg,
in obstetrics and gynecology. She is also a resident obstetrician at
So"dra A"lvsborg Hospital Women's Clinic in Boraas.

"An anal sphincter injury considerably raises the risk of accidental
bowel leakage later in life. With repetition of the injury, the risk
of persistent fecal incontinence is doubled. The degree of severity
also rises, with a higher frequency of leakage occasions, more severe incontinence, and a greater impact on quality of life," Nilsson states.

* RELATED_TOPICS
o Health_&_Medicine
# Urology # Women's_Health # Healthy_Aging # Menopause
# Gynecology # Bladder_Disorders # Teen_Health #
Pregnancy_and_Childbirth
* RELATED_TERMS
o Urinary_incontinence o Fecal_incontinence o Constipation
o Irritable_bowel_syndrome o Fertility o Breast_cancer o
Longevity o HPV_vaccine

========================================================================== Story Source: Materials provided by University_of_Gothenburg. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Ida E.K. Nilsson, Sigvard AAkervall, Mattias Molin, Ian Milsom,
Maria
Gyhagen. Severity and impact of accidental bowel leakage two
decades after no, one, or two sphincter injuries. American Journal
of Obstetrics and Gynecology, 2022; DOI: 10.1016/j.ajog.2022.11.1312 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/02/230223132921.htm

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