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        "name": "Anal Canal", 
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        "name": "Fecal Incontinence", 
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          "alternateName": "Department of Surgery, Technical University Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany, Germany", 
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    "datePublished": "2002-05-18", 
    "datePublishedReg": "2002-05-18", 
    "description": "Purpose. Disturbance of anal continence is a well-known problem after vaginal delivery. However, only few and incongruent data on the incidence and pathogenesis of postpartum incontinence are available. This study examined the effects of vaginal delivery on anal continence prospectively.Methods. In 42 unselected women anal vector manometry and endoanal ultrasonography were performed, and pudendal nerve terminal motor latency (PNTML) and rectal sensibility were measured in the 32th week of pregnancy and 6\u00a0weeks after delivery. Continence was evaluated according to the Kelly-Holschneider score. Patients with occult sphincter defects were additionally followed-up 12\u00a0weeks after vaginal delivery. To exclude any effect of pregnancy alone ten patients with elective cesarian section served as controls.Results. Overall continence after vaginal delivery did not differ significantly from that before delivery, there was a significant reduction in postpartum anal squeeze and resting pressures in all patients. Obstetric tears of grade III or IV occurred in 9% of the patients. Endosonography revealed occult lesions of the internal and external anal sphincter in an additional 19% of women who clinically seemed to have an intact sphincter. Manometric results and continence in these women did not differ significantly from those with intact sphincter and remained unchanged after 12\u00a0weeks. PNTML and rectal sensibility were not affected by vaginal delivery. After cesarian section there were no changes in continence, anal pressures, rectal sensibility, or PNTML.Conclusions. Vaginal delivery leads to direct mechanical trauma to the anal sphincters, while stretch and distension of the pudendal nerve seem to be of minor importance. Only endoanal ultrasonography is suitable for detection of occult sphincter lesions.", 
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        "issn": [
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          "1435-2451"
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        "name": "Langenbeck's Archives of Surgery", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
      }, 
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      "pudendal nerve terminal motor latency", 
      "vaginal delivery", 
      "rectal sensibility", 
      "anal continence", 
      "cesarean section", 
      "intact sphincter", 
      "anal sphincter", 
      "endoanal ultrasonography", 
      "nerve terminal motor latency", 
      "anal vector manometry", 
      "occult sphincter defects", 
      "anal sphincter morphology", 
      "terminal motor latency", 
      "elective cesarean section", 
      "weeks of pregnancy", 
      "effect of pregnancy", 
      "external anal sphincter", 
      "postpartum incontinence", 
      "vector manometry", 
      "overall continence", 
      "anal squeeze", 
      "obstetric tear", 
      "motor latency", 
      "anal pressure", 
      "pudendal nerve", 
      "sphincter lesions", 
      "sphincter defects", 
      "prospective study", 
      "grade III", 
      "occult lesions", 
      "manometric results", 
      "sphincter morphology", 
      "continence", 
      "mechanical trauma", 
      "sphincter", 
      "patients", 
      "weeks", 
      "incontinence", 
      "pregnancy", 
      "ultrasonography", 
      "significant reduction", 
      "lesions", 
      "women", 
      "delivery", 
      "manometry", 
      "nerve", 
      "endosonography", 
      "distension", 
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      "control", 
      "defects", 
      "reduction", 
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      "disturbances", 
      "sensibility", 
      "sections", 
      "changes", 
      "function", 
      "data", 
      "detection", 
      "importance", 
      "stretch", 
      "results", 
      "morphology", 
      "squeeze", 
      "problem"
    ], 
    "name": "Childbirth and incontinence: a prospective study on anal sphincter morphology and function before and early after vaginal delivery", 
    "pagination": "101-107", 
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    "sdDatePublished": "2022-05-20T07:22", 
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