 Childbirth injury can be repaired later
Source: Reuters Date: 07/07/08
For women who suffer an anal tear during childbirth, delaying surgical repair of the injury for up to 12 hours does not seem to harm long-term recovery, according to a new study.
Ruptures
to the anal sphincter during childbirth can cause long-term
incontinence, pain and other problems for many women, so serious tears
are usually surgically repaired, often immediately after delivery.
However, a surgeon with expertise in the repair is not always immediately available.
To see whether
delaying the procedure affects women's long-term recovery, Swedish
researchers randomly assigned 165 women with anal sphincter tears to
receive surgery either right after delivery or 8 to 12 hours later.
Over the next
year, there were no significant differences in incontinence symptoms
between the two groups, the researchers report in the obstetrics
journal BJOG.
By the one-year
mark, most women in both surgery groups said they "never" had fecal
incontinence, report Dr. J. Nordenstam and colleagues at the Karolinska
Institute in Stockholm.
Gas incontinence was a continuing problem for about half of the women in each group.
The findings,
according to Nordenstam's team, suggest that "there is no benefit or
harm" from delaying repair of anal sphincter tears for up to 12 hours.
Surgery should
not routinely be delayed, the researchers say, but in cases where an
experienced surgeon is not readily available, women can wait to have
the procedure.
SOURCE: BJOG, June 2008.
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