Información del artículo
Abstract
Faecal incontinence is underestimated in most epidemiological studies, probably because women may feel unable to discuss the symptoms they experience and avoid seeking medical advice. The most common cause of faecal incontinence in healthy women is an injury during a vaginal delivery. In this article we review the classification and terminology, as well as the risk factors, for third and fourth degree perineal tears. We also comment on the different suture techniques, the follow-up of women who sustain third and fourth degree tears and the advice given to those women regarding future pregnancies and mode of delivery. We highlight the importance of the endoanal ultrasound on the diagnosis of occult anal sphincter injury.
Keywords:
Anal sphincter injury
Delivery
Faecal incontinence
Resumen
La incontinencia fecal es una condición subestimada en los estudios epidemiológicos debido a que muchas mujeres no acuden al médico a pesar de padecerla. La causa más frecuente de incontinencia fecal en las mujeres sanas es el traumatismo de etiología obstétrica. En este artículo se revisa la clasificación y la terminología, así como los factores de riesgo predisponentes a presentar una lesión obstétrica perineal de tercer y cuarto grado. También se repasan las diferentes técnicas de sutura y el seguimiento óptimo ulterior de las mujeres que sufren desgarros perineales, así como la conducta a seguir en las futuras gestaciones. Se recalca la importancia de la ecografía endoanal en el diagnóstico correcto de lesiones ocultas perineales de etiología obstétrica.
Palabras clave:
Lesión del esfínter anal
Parto
Incontinencia fecal
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