A tear involving the anal sphincter during vaginal delivery has great bearing on a woman's future continence.
Whether it is a partial or complete laceration, periurethral tears and vaginal trauma are very serious and complicated injuries. Rupture of the external anal sphincter during childbirth also demands careful medical attention as it has the potential to be a devastating injury
If unrecognised or inadequately repaired, these complications can lead to anal incontinence, urinary incontinence and, in the worst scenario, fistula formation.
Immediate anal sphincter repair should be done to minimize the injuries. If the expertise is not available, the patient can be transferred to another center and a primary repair can be done.
Primary repair ensures a woman has the best chance of making a full recovery. She may experience a few complications to begin with, especially with regard to faecal incontinence. However, as long as a competent repair is performed, it is likely a woman will regain normal function.
If a sphincter injury is not detected at the time of the delivery, a woman will soon develop problems. This is likely to include faecal urgency and incontinence. Any woman who has recently given birth and who is experiencing such issues should undergo further medical investigation. If a third or fourth degree tear is subsequently diagnosed, an appropriate course of treatment should be devised to help a woman cope with her symptoms, which includes shincter repair
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