ABSTRACT
Obstetric anal sphincter injuries (OASIS) are the major cause of anal incontinence and can have a devastating effect on women's quality of life. Until the advent of anal endosonography, the cause was attributed largely to pelvic neuropathy. However, despite identification and immediate repair of OASIS, the outcome reported in earlier studies was suboptimal as more than a third of women suffer from impaired continence. Since the introduction of new classification and hands-on workshops, the identification and results following primary repair have improved. The majority of the obstetricians perform the immediate primary repair for OASIS with variable reported outcomes using validated symptom questionnaires, endoanal ultrasound scan defects, and anal manometry findings. Evidence for the mode of the subsequent delivery following OASIS is currently based on the symptoms, anal sphincter defects, and anal manometry findings. New outcome data is presented based on recent studies using the Sultan classification of OASIS.
