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Anal sphincter injury, fecal and urinary incontinence: a 34-year follow-up after forceps delivery

Bollard, Ruth C.; Gardiner, Angela; Duthie, Grahame S.; Lindow, Stephen W.


Ruth C. Bollard

Angela Gardiner

Grahame S. Duthie

Stephen W. Lindow


PURPOSE: This study was designed to determine the long-term outcome of forceps delivery in terms of evidence of anal sphincter injury and the incidence of fecal and urinary incontinence. METHODS: Women who delivered in 1964 were evaluated by using endoanal ultrasound, manometry, and a continence questionnaire. Women delivered by forceps were matched with the next normal delivery and elective cesarean delivery in the birth register. RESULTS: The women's overall obstetric history was evaluated. Women who had ever had a forceps delivery (n = 42) had a significantly higher incidence of sphincter rupture compared with women who had only unassisted vaginal deliveries (n = 41) and elective cesarean sections (n = 6) (44 vs. 22 vs. 0 percent; chi-squared 7.09; P = 0.03). There was no significant difference in the incidence of significant fecal incontinence between the three groups (14 vs. 10 vs. 0 percent) or significant urinary incontinence (7 vs. 19 vs. 0 percent). CONCLUSION: Anal sphincter injury was associated with forceps delivery in the past; however, significant fecal and urinary incontinence was not.


Bollard, R. C., Gardiner, A., Duthie, G. S., & Lindow, S. W. (2003). Anal sphincter injury, fecal and urinary incontinence: a 34-year follow-up after forceps delivery. Diseases of the colon & rectum, 46(8), 1083-1088. doi:10.1007/s10350-004-7284-8

Journal Article Type Article
Acceptance Date Aug 31, 2003
Publication Date 2003-08
Journal Diseases of the colon and rectum
Print ISSN 0012-3706
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 46
Issue 8
Pages 1083-1088
Keywords Gastroenterology; General Medicine
Public URL
PMID 12907903