Anterior sphincteroplasty based on integral theory of pelvic floor for the treatment of fecal incontinence caused by third-and fourth-degree perineal tears
XU Zhen-peng
SUN Gui-dong
CHEN Yu-gen
SHAO Wan-jin
Abstract：The incidence of perineal lacerations and levator ani muscle injuries during delivery is high,especially third-and fourth-degree perineal tears(also referred to as obstetric anal sphincter injuries-OASIS),which may lead to fecal incontinence.Perineal injury should be identified early and repaired promptly.However,more than half of OASIS are not discovered in the delivery room.OASIS can be evaluated and diagnosed by perineal examination,digital rectal examination combined with auxiliary examinations such as endorectal ultrasound,transperineal ultrasound,and rectal magnetic resonance imaging.When conservative treatment for OASIS is ineffective,anterior anal sphincteroplasty is the main treatment for OASIS.For patients with levator ani muscle injury,levator ani muscle plasty should be performed simultaneously.However,its clinical effect will decrease significantly over time.In view of this,the author recommends that other treatment methods such as biofeedback,electroacupuncture,sacral nerve stimulation,etc.can be used in combination after anal sphincteroplasty to enhance or maintain clinical effects.
Keywords：obstetric anal sphincter injuriesfecal incontinenceanterior sphincteroplastylevator ani muscle plasty
Publication Date：2025-05-02
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 502-507 )