The relationship between fecal incontinence and vaginal delivery in the postmenopausal stage
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Dosyalar
Tarih
2017
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Obstetrik anal sfinkter yaralanmaları vajinal doğumların önemli bir komplikasyonudur ve istemsiz gaz, sıvı veya katı gaita kaçağı olarak tanımlanan fekal inkontinanslara neden olmaktadırlar. Tüm doğumların %0,5-9'unda sfinkter yaralanması görülmesine rağmen endoanal ultrasonografinin kullanıma girmesiyle vajinal doğum yapmış kadınların %20-41'inde okült anal sfinkter yaralanmaları olduğu tespit edilmiştir. Çalışmamızın amacı postmenapozal dönemde insidansı dramatik artan fekal inkontinansların okült anal sfinkter yaralanmaları ile ilişkisinin incelenmesidir. Gereç ve Yöntemler: Anal sfinkter yaralanması öyküsü olmayan 18-70 yaş arası 200 sağlıklı kadın çalışmaya alındı. Katılımcılar premenapozal ve postmenapozal vajinal doğum; premenapozal ve postmenaozal sezaryenle doğum yapanlar olmak üzere 4 gruba ayrıldı. Katılımcılar menapoz durumu ve doğum türüne göre 4 gruba ayrıldı. Wexner inkontinans skorları belirlendi. Katılımcıların anal sfinkter defektleri endoanal ultrason ile anal sfinkter fonksiyonları ise anorektal manometer ile değerlendirildi.Bulgular: Grup 1'de anorektal manometre ölçüm değerleri grup 3'ten anlamlı olarak daha düşük bulundu (p0,01). Grup 1 ve grup 3 arasında Wexner skoru benzerdi. Grup 2'nin anorektal manometrik ölçüm değerleri grup 4'ten anlamlı olarak daha düşüktü. Wexner skoru ise grup 2'de anlamlı olarak daha yüksekti (p0,03). Sonuç: Vajinal doğum sonrası oluşan anal sfinkter yaralanmaları kadınlarda menapoz sonrası fekal inkontinansların insidansının artmasına ve fekal inkontinans semptomların oluşmasına neden olan bir faktör olabilir.
Objective: Obstetric anal sphincter injuries are one of the most significant complications of vaginal delivery that give way to fecal incontinence, which is defined as the involuntary leakage of gas, fluid or solid stool. Although sphincter injuries are seen in 0.5-9% of all deliveries. It has been reported that 20-41% of women who had vaginal deliveries had occult anal sphincter injuries as endoanal ultrasonography began to be used by physicians. The aim of our study was to investigate the relationship between fecal incontinence, whose incidence increases dramatically during the postmenopausal stage, and occult anal sphincter injuries.Materials and Methods: Two hundred healthy female patients with no history of anal sphincter injury, aged between 18 and 70 years were included in the study. The participants were divided into 4 groups according to their menopausal stages and mode of delivery; premenopausal (group 1) and postmenopausal (group 2) vaginal delivery, and premenopausal (group 3) and postmenopausal (group 4) cesarean section. Wexner incontinence scores were determined. The participants’ defects were assessed using endoanal ultrasound and their status of fecal incontinence using anorectal manometric measurements. Results: Anorectal manometric measurement results were found significantly lower in group 1 than in group 3 (p0.01). The Wexner scores of groups 1 and 3 were similar. The anorectal manometric measurement results of group 2 were significantly lower than those of group 4, and the Wexner score of group 2 was significantly higher than other groups (p0.03). Conclusion: Anal sphincter injuries formed after vaginal delivery may be one of the reasons that increase the incidence of postmenopausal fecal incontinence and cause the formation of fecal incontinence symptoms in women.
Objective: Obstetric anal sphincter injuries are one of the most significant complications of vaginal delivery that give way to fecal incontinence, which is defined as the involuntary leakage of gas, fluid or solid stool. Although sphincter injuries are seen in 0.5-9% of all deliveries. It has been reported that 20-41% of women who had vaginal deliveries had occult anal sphincter injuries as endoanal ultrasonography began to be used by physicians. The aim of our study was to investigate the relationship between fecal incontinence, whose incidence increases dramatically during the postmenopausal stage, and occult anal sphincter injuries.Materials and Methods: Two hundred healthy female patients with no history of anal sphincter injury, aged between 18 and 70 years were included in the study. The participants were divided into 4 groups according to their menopausal stages and mode of delivery; premenopausal (group 1) and postmenopausal (group 2) vaginal delivery, and premenopausal (group 3) and postmenopausal (group 4) cesarean section. Wexner incontinence scores were determined. The participants’ defects were assessed using endoanal ultrasound and their status of fecal incontinence using anorectal manometric measurements. Results: Anorectal manometric measurement results were found significantly lower in group 1 than in group 3 (p0.01). The Wexner scores of groups 1 and 3 were similar. The anorectal manometric measurement results of group 2 were significantly lower than those of group 4, and the Wexner score of group 2 was significantly higher than other groups (p0.03). Conclusion: Anal sphincter injuries formed after vaginal delivery may be one of the reasons that increase the incidence of postmenopausal fecal incontinence and cause the formation of fecal incontinence symptoms in women.
Açıklama
WOS:000401943300006
PubMed ID:28913133
PubMed ID:28913133
Anahtar Kelimeler
Fecal incontinence, Obstetric sphincter injury, Postmenopausal stage, Fekal inkontinans, Obstetrik sfinkter yaralanması, Postmenapozal durum
Kaynak
Turkish Journal of Obstetrics and Gynecology
WoS Q Değeri
Scopus Q Değeri
Q3
Cilt
14
Sayı
1
Künye
Ataseven, H., , Çakır, M., Kaynak, A., Kargın, S., Çifçi, S., Kadıyoran, C. (2017). The relationship between fecal incontinence and vaginal delivery in the postmenopausal stage. Turkish Journal of Obstetrics and Gynecology, 14, 1, 37-44.
