Bowel Incontinence From Childbirth Not Cured by Surgery
"There is room for reasonable disagreement among physicians as to whether it is advisable to overlap muscle tissue, [as was done by these investigators]," Leslie A. Sharpe, MD, tells WebMD. "Another repair technique ... sews into the sphincter's surrounding tissue. ... These two techniques may differ in how well the repair holds up over time." Sharpe, a clinical associate professor of obstetrics and gynecology at the University of Minnesota in Minneapolis and an attending physician at Health Partners and Regions Hospital in St. Paul, Minn., was not involved in the study.
"Awareness of ... fecal incontinence after vaginal delivery is growing," Michael Moen, MD, tells WebMD in an independent interview. "However, this study has limitations. For example, there was no information for 14% of the patients. ... We don't know whether the patients' problems were related to the repair or to other bowel problems." Moen is a staff gynecologist at Lutheran General Hospital in Chicago.
Women with mild symptoms may want to try conservative measures first, Norton tells WebMD. These include reducing fiber and caffeine in the diet and Kegel exercises, which involve alternately squeezing and releasing the sphincter muscles to build their strength.
- Many women who undergo surgery to repair an anal sphincter damaged during childbirth may initially experience relief, but go on to have bowel problems later.
- Researchers suggest that only those with the most severe symptoms should opt for the surgery, while those with mild symptoms should consider conservative treatment.
- A forceps-assisted birth, large baby, and position of the baby during delivery can increase the risk of damage, and episiotomy does not help to prevent damage.