UK survey of colorectal surgeons on the management of acute obstetric anal sphincter injuries

Colorectal Dis. 2024 Jan;26(1):130-136. doi: 10.1111/codi.16820. Epub 2023 Dec 26.

Abstract

Aim: The role of colorectal surgeons in the management of acute obstetric anal sphincter injury (OASI) is an ongoing debate. Their expertise in operating in the anorectal region lends itself to assisting in OASI repair. The aim of this study was to establish the current involvement and recommended management of acute OASI by colorectal surgeons.

Method: An online survey of consultant colorectal surgeons was sent to members of the Pelvic Floor Society to assess current involvement in acute OASI management and repair.

Results: Forty completed surveys were collated and analysed. Sixty-five per cent of respondents had seen an acute OASI since being a consultant and 50% stated they were involved in the repair of OASI less than once per year. 37.5% felt that a de-functioning stoma was still necessary sometimes. Many agreed with current guidelines for OASI repair in terms of antibiotics, laxatives and follow-up.

Conclusions: Colorectal surgeons have varied opinions on the management of OASI. We suggest that multidisciplinary training of obstetricians and colorectal surgeons could lead to more collaboration regarding the management of women with acute OASI.

Keywords: colorectal surgeon; obstetric anal sphincter injury; survey.

MeSH terms

  • Anal Canal / injuries
  • Anal Canal / surgery
  • Colorectal Neoplasms*
  • Delivery, Obstetric / adverse effects
  • Fecal Incontinence* / surgery
  • Female
  • Humans
  • Obstetric Labor Complications* / surgery
  • Pregnancy
  • Risk Factors
  • Surgeons*
  • Surveys and Questionnaires
  • United Kingdom