Does perineal body thickness affect fecal incontinence in multiparous patients?

Abstract

Background: Obstetric trauma is the mostcommon cause of fecal incontinence in multiparous women.The literature has shown that women with obstetric trauma to the anal sphincter have decreased perineal body thickness (PBT).We aimed to analyze the role of PBT by endoanalultrasonographyinassessment of this type of fecal incontinence in multiparous patients. Methods : Forty-fourfemales with anal incontinence and 36 asymptomatic ones that had two or more previous deliveries were investigated with endoanalultrasonographyfrom January2016 to December 2016. All patients were divided into three groups on thebasis of PBT: 10 mm or less, 10 to 12 mm, more than12 mm. The degree of FI was measured using the incontinence score of Wexner. Sphincter angle defect was separately measured for each patient. Results : The mean age of all our 80 patients was 46.9±1.3 years (26–77 years) and the mean PBT in incontinent patients was 8.78 ± 2.84 mm and 12.65± 16.76mm in asymptomatic subjects (P < 0.001). The mean Wexner score was 8.6 (2-20 in incontinent patients). External sphincter defect angles were negatively correlated with PBT (p = 0.045).For 89% of the patients there was a history of vaginal delivery and 62.5% had undergone one or more prior episiotomies during delivery. Conclusion : A PBT less than 10 mm is associated with sphincter defect in most incontinent patients. Perineal body thickness plays such a significantly important role in fecal incontinence that it should be one of the factors involved in anal incontinency evaluations.