Social Impact of Faecal Incontinence in Postpartum Women

Anal incontinence can have devastating effect on women's quality of life, and vaginal delivery has been implicated as a significant causal factor. The present study was designed to evaluate the degree of ano-rectal dysfunction following vaginal delivery.

185 women before delivery and 150 of them after delivery were included in the study. All patients were subjected to an interview, endoanal ultrasonography, anorectal manometry and pudendal nerve terminal motor latency.

Endoanal sonography results showed no detectable sphincter defect before delivery in primiparous women. After delivery over third had defects of the internal sphincter, the external sphincter or both. 44% of the multiparous women had multiple sphincter defects after delivery. The maximum resting pressure was significantly lower after delivery in both the primiparous and the multiparous women. Squeeze pressures were lower and pudendal nerve terminal motor latency was also prolonged, resulting in varying degree of faecal incontinence.

Women with faecal incontinence suffered varying degree of problems ranging from reluctance to go shopping to not leaving the house at all. Over 60% of such women also suffered problems with personal relationship. Over 3% of the multiparous women blamed faecal incontinence as the cause of break down of their personal relationships