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 patient..