Postpartum fecal incontinence

Introduction Perineal III degree laceration is a complication of vaginal delivery, but it is rare. If the suture is not repaired in time, it can lead to fecal incontinence or fecal leakage, which brings great pain and inconvenience to the mother. The main symptoms are fecal incontinence, partial or complete rupture of the anal sphincter, and even rupture of the anterior muscle and damage to the anterior rectal wall.

Cause

Complete perineal laceration is mainly caused by severe laceration of the pelvic floor tissue caused by birth injury, including levator ani muscle and anal sphincter (the anal internal sphincter is formed by the inner ring muscle of the rectal wall descending to the anal canal, due to its Located on the inner side of the anal canal, it is called the anal internal sphincter. The average width is about 3 cm and the thickness is 0.5 cm. It is around the upper 2/3 of the anal canal. Its periphery is combined with the deep and shallow of the longitudinal and anal external sphincters. The two layers of muscle fibers are surrounded by a smooth muscle, which is dominated by autonomic nerves, which are involuntary muscles and are not controlled by consciousness. In severe cases, the rupture can extend to the rectal wall, causing fecal incontinence.

an examination

Related inspection

Conventional pelvic floor electromyography pelvic CT examination

The complete perineal laceration occurs in the second stage of labor. When the fetal head is crowned, the midwife may perceive a peristaltic tear. Wound healing is generally good if the wound is completely lacerated after delivery. The main symptoms are fecal incontinence, partial or complete rupture of the anal sphincter, and even rupture of the anterior muscle and damage to the anterior rectal wall. For those who have old lacerations, one finger extends into the anus during the examination, and the patient is forced to contract inwardly by means of holding the stool. At this time, the anal finger does not feel the contraction of the sphincter, and the muscle is broken due to tearing. Shrink, a small depression can be seen on the side of the anus, and a ring-shaped muscle break can be found at the tear.

Differential diagnosis

If you are free to control the dry, but lose control of the thin stools and gases, called incomplete or semi-incontinence. No matter what kind of performance of the anus can not be closed, it is round open, cough, walking, squatting, sleep, often have fecal mucus outflow, contaminating underwear, so that the anus is wet, itching is called complete incontinence.

The complete perineal laceration occurs in the second stage of labor. When the fetal head is crowned, the midwife may perceive a peristaltic tear. Wound healing is generally good if the wound is completely lacerated after delivery. The main symptoms are fecal incontinence, partial or complete rupture of the anal sphincter, and even rupture of the anterior muscle and damage to the anterior rectal wall.

For those who have old lacerations, one finger extends into the anus during the examination, and the patient is forced to contract inwardly by means of holding the stool. At this time, the anal finger does not feel the contraction of the sphincter, and the muscle is broken due to tearing. Shrink, a small depression can be seen on the side of the anus, and a ring-shaped muscle break can be found at the tear.

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