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Health Care–Seeking Characteristics of Women With Pelvic Floor Disorders After Obstetric Anal Sphincter Injury

Pennycuff, Jon F. MD, MSPH*; Karp, Deborah R. MD; Shinnick, Julia MD; Hudson, Catherine O. MD§; Northington, Gina M. MD, PhD*

Female Pelvic Medicine & Reconstructive Surgery: April 6, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000583
Original Article: PDF Only

Objectives Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS.

Methods This study is a retrospective cohort study of 69 women who developed pelvic floor disorders after OASIS.

Results For women diagnosed with a pelvic floor symptom, the mean time to follow-up was 2.4 years, the mean number of visits until diagnosis was 2.2 visits, and 2.9 visits were needed for treatment. The most common diagnoses were pelvic pain, lower urinary tract symptoms including incontinence, and defecatory dysfunction. Twenty-five percent of the cohort received treatment from a pelvic floor specialist. These women were more likely to be older and have urinary incontinence. Women with pain were more likely to be seen by a primary care provider and have longer time to diagnosis.

Conclusions The study showed that multiple visits were needed to both diagnose and treat pelvic floor disorders (PFD) after OASIS. Pelvic pain was the most common primary PFD after OASIS. There should be a high level of suspicion for pelvic floor disorders, especially pain disorders, in women who have sustained a third- or fourth-degree laceration.

From the *Department of Gynecology and Obstetrics, Emory University School of Medicine; †Women’s Services, Wellstar Health, Atlanta, GA; ‡Department of Obstetrics and Gynecology, The Warren Alpert Medical School, Brown University, Providence, RI; and §Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH.

Correspondence: Jon F. Pennycuff, MD, MSPH, 69 Jesse Hill Jr Dr, SE Atlanta, GA 30303. E-mail:

The authors have declared they have no conflicts of interest.

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