Does perineal body thickness affect faecal incontinence in multiparous patients?

Abstract

Background. Obstetric trauma is the most common cause of faecal incontinence in multiparous women. The literature has shown that women with obstetric trauma to the anal sphincter have decreased perineal body thickness (PBT). Objective. To determine the role of PBT in the assessment of this type of faecal incontinence in multiparous patients. Methods. Forty-four women with faecal incontinence, and 36 asymptomatic women who had had two or more previous deliveries, were investigated with endoanal ultrasonography from January to December 2016. The patients were divided into three groups on the basis of PBT: <10 mm, 10 - 12 mm and >12 mm. The degree of faecal incontinence was measured using the Wexner faecal incontinence score. Sphincter angle defect was separately measured for each patient. Results. The mean (standard error) age of all of our 80 patients was 46.9 (1.3) years (range 26 - 77 years), and the mean PBT in incontinent patients was 8.78 (2.84) mm, and 12.65 (16.76) mm in asymptomatic subjects (p<0.001). The mean Wexner score was 8.6 (range 2 - 20) in incontinent patients. External anal sphincter defect angles were negatively correlated with PBT (p=0.045). For 89% of the patients, there was a history of vaginal delivery, and 62.5% had undergone one or more prior episiotomies during delivery. A PBT <10 mm was associated with sphincter defect in most incontinent patients. Conclusion. PBT plays a significantly important role in faecal incontinence, so it is recommended that it should be one of the factors involved in anal incontinency evaluations.