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114 Anal Sphincter Injury, Fecal and Urinary Incontinence [2003년 8월 DCR] 2011-11-17 3463
 
A 34-Year Follow-Up After Forceps Delivery
 
Ruth C. Bollard, M.B.,* Angela Gardiner, B.Sc.,* Grahame S. Duthie, M.D.,*Stephen W. Lindow, M.D.†
 
From the *Academic Surgical Unit, University of Hull, Castle Hill Hospital, Cottingham North Humberside, United Kingdom, and the †Academic Department of Obstetrics and Gynaecology, Hull Maternity Hospital, Hull, United Kingdom
 
PURPOSE: This study was designed to determine the longterm outcome of forceps delivery in terms of evidence of anal sphincter injury and the incidence of fecal and urinary incontinence.
METHODS: Women who delivered in 1964 were evaluated by using endoanal ultrasound, manometry,
and a continence questionnaire. Women delivered by forceps were matched with the next normal delivery and elective cesarean delivery in the birth register.
RESULTS: The women’s overall obstetric history was evaluated. Women who had ever had a forceps delivery (n = 42) had a significantly higher incidence of sphincter rupture compared with women who had only unassisted vaginal deliveries (n = 41) and elective cesarean sections (n = 6) (44 vs.22 vs. 0 percent; chi-squared 7.09; P = 0.03). There was no significant difference in the incidence of significant fecal incontinence between the three groups (14 vs. 10 vs. 0 percent) or significant urinary incontinence (7 vs. 19 vs. 0 percent).
CONCLUSION: Anal sphincter injury was associated with forceps delivery in the past; however, significant fecal and urinary incontinence was not.