2021 Volume 46 Issue 6 Pages 698-702
Anal sphincter injury during vaginal delivery can cause intractable fecal incontinence. Although a variety of surgical procedures have been attempted, none has been demonstrated until now to definitively yield satisfactory outcomes. We present the case report of a patient who underwent successful surgical treatment for obstetric trauma-induced fecal incontinence.
A 29-year-old Japanese woman with a history of perineal tear during her first delivery presented to our hospital with severe fecal incontinence. Digital examination revealed complete disruption of the perineal body caused by vaginal birth-induced trauma, as well as of the external anal sphincter in front of the anterior rectal wall. We considered that additional repair of the lacerated perineal body would be more effective than anal sphincter repair alone to resolve the fecal continence. Therefore, surgical reconstruction of the lacerated perineal body was performed under spinal anesthesia with the patient placed in the jackknife position. Postoperatively, the patient was successfully relieved of the fecal continence, without any complications. Our new technique of perineal body-plasty can be an effective treatment option for obstetric trauma-induced fecal incontinence.
