Perineal examination as a predictor of underlying external anal sphincter damage

Abstract

Objective To assess the relation between perineal inspection and sphincter integrity in parous women. Design Prospective observational study. Setting District general hospital. Population Fifty-seven consecutive parous women attending a gynaecology clinic for problems unrelated to the pelvic floor. Methods A detailed history of bowel function and mode of delivery obtained; the perineum inspected to determine the presence and position of scarring, and anal endosonography performed. Results In 19 women with an intact perineum on inspection, endosonography showed perineal scarring in five, with both perineal and sphincter scarring in three. Four had urge faecal incontinence. Three patients had ..