Advanced

Correlations of obstetric anal sphincter injury (OASIS) grade, specific symptoms of anal incontinence, and measurements by endoanal and transperineal ultrasound

Ignell, Claes LU ; Örnö, Ann Kristin LU and Stuart, Andrea LU (2020) In Journal of Ultrasound
Abstract

Purpose: The aim of the study was to investigate the association between the initial grade of obstetrical anal sphincter injury (OASIS), and Wexner score parameters, with ultrasonographic findings by endoanal ultrasound (EAUS, golden standard) and transperineal ultrasound (TPUS) 6 months post-partum. Methods: Fifty-nine women after primary repair of OASIS were included at Helsingborg Hospital, Sweden, 2016–2017. Six months post-partum the women filled in a questionnaire regarding symptoms of anal incontinence by the Wexner score and were scanned with EAUS and TPUS (resting state and contracting state) for classification of the residual defect by a modified Starck score. Results: Correlations were found between the OASIS grade and... (More)

Purpose: The aim of the study was to investigate the association between the initial grade of obstetrical anal sphincter injury (OASIS), and Wexner score parameters, with ultrasonographic findings by endoanal ultrasound (EAUS, golden standard) and transperineal ultrasound (TPUS) 6 months post-partum. Methods: Fifty-nine women after primary repair of OASIS were included at Helsingborg Hospital, Sweden, 2016–2017. Six months post-partum the women filled in a questionnaire regarding symptoms of anal incontinence by the Wexner score and were scanned with EAUS and TPUS (resting state and contracting state) for classification of the residual defect by a modified Starck score. Results: Correlations were found between the OASIS grade and residual defects; length (rs = 0.41, P = 0.003), depth (rs = 0.38, P = 0.006) and angle (rs = 0.40, P = 0.004) of the external anal sphincter (EAS) measured with TPUS in resting state. Using EAUS, correlation between OASIS grade and EAS depth (rs = 0.35, P = 0.007) and angle (rs = 0.37, P = 0.004) were similar, but there was no correlation with length (rs = 0.20, P = 0.14). Between incontinence to gas and the angle of the residual defect in the IAS using TPUS in resting state, correlation was moderate (rs = 0.42, P = 0.003). Regarding incontinence to liquid stool, measurements by TPUS in resting state of EAS residual defect depth (rs = 0.46, P < 0.001) and angle (rs = 0.44, P = 0.001) also correlated moderately. Both corresponding correlations using EAUS were weaker. Conclusion: Defects measured with EAUS and TPUS six months post-partum correlated to initial OASIS grade and symptoms of anal incontinence. Specific symptoms correlated with specific anatomical defects, and TPUS was not an inferior method to EAUS.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Endoanal ultrasound, Obstetrical anal sphincter injury, Transperineal ultrasound, Wexner score
in
Journal of Ultrasound
publisher
Springer
external identifiers
  • scopus:85085684111
  • pmid:32476092
ISSN
1876-7931
DOI
10.1007/s40477-020-00485-4
language
English
LU publication?
yes
id
fb35fa0a-e200-4bb3-8cd1-dfe8632a508f
date added to LUP
2020-06-25 13:19:02
date last changed
2020-06-26 03:00:03
@article{fb35fa0a-e200-4bb3-8cd1-dfe8632a508f,
  abstract     = {<p>Purpose: The aim of the study was to investigate the association between the initial grade of obstetrical anal sphincter injury (OASIS), and Wexner score parameters, with ultrasonographic findings by endoanal ultrasound (EAUS, golden standard) and transperineal ultrasound (TPUS) 6 months post-partum. Methods: Fifty-nine women after primary repair of OASIS were included at Helsingborg Hospital, Sweden, 2016–2017. Six months post-partum the women filled in a questionnaire regarding symptoms of anal incontinence by the Wexner score and were scanned with EAUS and TPUS (resting state and contracting state) for classification of the residual defect by a modified Starck score. Results: Correlations were found between the OASIS grade and residual defects; length (r<sub>s</sub> = 0.41, P = 0.003), depth (r<sub>s</sub> = 0.38, P = 0.006) and angle (r<sub>s</sub> = 0.40, P = 0.004) of the external anal sphincter (EAS) measured with TPUS in resting state. Using EAUS, correlation between OASIS grade and EAS depth (r<sub>s</sub> = 0.35, P = 0.007) and angle (r<sub>s</sub> = 0.37, P = 0.004) were similar, but there was no correlation with length (r<sub>s</sub> = 0.20, P = 0.14). Between incontinence to gas and the angle of the residual defect in the IAS using TPUS in resting state, correlation was moderate (r<sub>s</sub> = 0.42, P = 0.003). Regarding incontinence to liquid stool, measurements by TPUS in resting state of EAS residual defect depth (r<sub>s</sub> = 0.46, P &lt; 0.001) and angle (r<sub>s</sub> = 0.44, P = 0.001) also correlated moderately. Both corresponding correlations using EAUS were weaker. Conclusion: Defects measured with EAUS and TPUS six months post-partum correlated to initial OASIS grade and symptoms of anal incontinence. Specific symptoms correlated with specific anatomical defects, and TPUS was not an inferior method to EAUS.</p>},
  author       = {Ignell, Claes and Örnö, Ann Kristin and Stuart, Andrea},
  issn         = {1876-7931},
  language     = {eng},
  month        = {05},
  publisher    = {Springer},
  series       = {Journal of Ultrasound},
  title        = {Correlations of obstetric anal sphincter injury (OASIS) grade, specific symptoms of anal incontinence, and measurements by endoanal and transperineal ultrasound},
  url          = {http://dx.doi.org/10.1007/s40477-020-00485-4},
  doi          = {10.1007/s40477-020-00485-4},
  year         = {2020},
}