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dc.contributor.authorRamage, Len_US
dc.contributor.authorYen, Cen_US
dc.contributor.authorQiu, Sen_US
dc.contributor.authorSimillis, Cen_US
dc.contributor.authorKontovounisios, Cen_US
dc.contributor.authorTan, Een_US
dc.contributor.authorTekkis, Pen_US
dc.date.accessioned2018-03-05T16:20:33Z
dc.date.issued2018-01en_US
dc.identifier.citationThe Annals of The Royal College of Surgeons of England, 2018, 100 (1), pp. 26 - 32en_US
dc.identifier.issn0035-8843en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1568
dc.identifier.eissn1478-7083en_US
dc.identifier.doi10.1308/rcsann.2017.0140en_US
dc.description.abstract<jats:sec><jats:title>Introduction</jats:title><jats:p> This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. </jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p> Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment. Outcomes compared included Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score, Short Form-36, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and anorectal physiology results. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Thirty-two missed anal sphincter injuries were matched two to one with sixty-two patients who underwent primary repair of an anal sphincter defect. Mean time to follow-up was 9.31 ± 6.79 months. Patients with a missed anal sphincter injury had suffered more incontinence, as seen in higher the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ; 30.56% ± 14.41% vs. 19.75% ± 15.65%, P = 0.002) and Wexner scores (6.00 ± 3.76 vs. 3.67 ± 4.06, P = 0.009). They also had a worse BBUSQ urinary domain score (28.25% ± 14.9% vs. 17.01 ± 13.87%, P = 0.001) and worse physical functioning as measured by the Short Form-36 questionnaire (P = 0.045). There were no differences in other outcomes compared, including anorectal physiology and sexual function. </jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p> In the short-term, patients with a missed obstetric anal sphincter injury had significantly worse faecal incontinence and urinary function scores, however quality of life and sexual function were largely comparable between groups. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Longer-term follow-up is needed to assess the effects of missed obstetric anal sphincter injury over time. </jats:p></jats:sec>en_US
dc.format.extent26 - 32en_US
dc.languageenen_US
dc.language.isoenen_US
dc.publisherRoyal College of Surgeons of Englanden_US
dc.titleDoes a missed obstetric anal sphincter injury at time of delivery affect short-term functional outcome?en_US
dc.typeJournal Article
rioxxterms.versionofrecord10.1308/rcsann.2017.0140en_US
rioxxterms.licenseref.startdate2018-01en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfThe Annals of The Royal College of Surgeons of Englanden_US
pubs.issue1en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume100en_US
pubs.embargo.termsNot knownen_US
dc.contributor.icrauthorMarsden,en_US


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