Endoanal scan IDs occult defects.(News)

MONTREAL -- Endoanal ultrasound performed immediately post partum can identify clinically occult anal sphincter defects, which are linked to an increased risk of anal incontinence, according to a British study.

"This technology can improve our prediction of incontinence and has the potential to be used to target postnatal follow-up to women at increased risk," said Philip Toozs-Hobson, M.D., a consultant gynecologist at Birmingham (England) Women's Hospital.

Speaking at the annual meeting of the International Continence Society, Dr. Toozs-Hobson outlined his study, which compared findings from endoanal ultrasounds performed immediately after delivery in 198 women with anal incontinence. Questionnaires were administered at 6 weeks post partum.

Clinical evidence of anal sphincter damage had been ruled out in all women after clinical examination by two separate assessors.

While 60% of study participants had intact external and internal anal sphincters seen on endoanal ultrasound, and 30% had an isolated external anal sphincter defect only, the remaining 10% of participants had either defects in both sphincters or such profound distortion of the sphincters that the anatomy was not interpretable.

Among this latter group, 30% of the women reported anal incontinence symptoms at 6 weeks post partum--which was threefold the rate of the rest of the study participants.

"A severely abnormal endoanal ultrasound scan immediately post partum increases the risk of anal incontinence three times when compared [with] women with a normal ultrasound or an isolated [external and sphincter] defect," Dr. Toozs-Hobson concluded.