Has primary overlap replaced end-to-end repair for anal sphincter rupture during vaginal delivery? | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 10, Volume 1, Issue 1, December 2000, Page 129-137 PDF (394.95 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2000.11024 | ||||
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| Authors | ||||
| Nagwa Abd El-Ghaffar Mohamed1; *Maha Abd El-Mongi Abd El-Rahman2 | ||||
| 1Department of Obstetrics and Gynaecology | ||||
| 2Department of General Surgery Faculty of Medicine for Girls Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Twenty primigravidae women were included in this study. Their age ranged from (20-32) years. They were requiring primary repair for third degree tear occurring during vaginal delivery. All repairs were performed immediately after obstetric disruption. A ruptured internal sphincter was repaired separately and the torn ends of the external sphincter were overlaped in 10 women and approximated as end-to-end in the other 10 women, and sutured with 3/0 polydioxanone sulphate sutures. Sixteen women were followed up, and for all bowel function, clinical assessement, and anal endosonography were performed at a mean of 120 days after delivary. Eleven percent had persistent sonographic external sphincter defects with overlap, and 57% with end to end repair. Also, we found similar percent of internal sphincter defects with overlap, and end-toend repair. There was no significant difference between the two techniques with regard to the clinical outcome. Based on the preceding results it would appear that sonographic image for external sphincter is better with overlap than end-to-end repair, but we can not conclusively prove that overlap is superior to the end-to-end repair for better clinical outcome obtained from both techniques. | ||||
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