Delivery-Linked Perineal Tears Can Bring Long-Term Trouble

But women are often too embarrassed to seek out help, researchers say

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FRIDAY, Sept. 9, 2005 (HealthDay News) -- Women who require surgical repair after suffering a fourth-degree perineal laceration during the birth of their first baby encounter more complications than women who experienced less-severe tearing, new research shows.

These types of tears to the perineum (the area between the genitalia and anus) can cause damage to the anal sphincter, sometimes resulting in long-term fecal incontinence, urgency, pain during intercourse or other problems.

After evaluating the problem, doctors typically treat these tears with physical therapy, dietary modifications and, if needed, surgery. Experts say many women may feel too embarrassed to seek help, however.

"This is an issue faced by many women who deliver vaginally and it is important that we educate women about the consequences of severe vaginal tears, especially mothers-to-be," lead author Dr. Catherine Nichols, assistant professor of obstetrics and gynecology at Virginia Commonwealth University, said in a prepared statement.

Reporting in the August issue of the American Journal of Obstetrics and Gynecology, her team found that bowel-related complications were more common after fourth-degree tear repair compared with third-degree tear repair. Women with fourth-degree repairs also were significantly more likely to have an increased rate of combined defects of the internal and external sphincters.

The study, involving 56 women, "demonstrates that third- and fourth-degree lacerations should not be collectively grouped together as 'severe perineal lacerations' because the outcomes appear to be significantly different," Nichols said.

More information

The American Academy of Family Physicians has more about perineal lacerations.

SOURCE: Virginia Commonwealth University, news release, Aug. 31, 2005

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