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Authordc.contributor.authorGuzmán Rojas, Rodrigo 
Authordc.contributor.authorAtan, I. Kamisan 
Authordc.contributor.authorShek, K. L. 
Authordc.contributor.authorDietz, H. P. 
Admission datedc.date.accessioned2015-12-02T18:54:03Z
Available datedc.date.available2015-12-02T18:54:03Z
Publication datedc.date.issued2015
Cita de ítemdc.identifier.citationUltrasound in Obstetrics & Gynecology 2015; 46: 363–366en_US
Identifierdc.identifier.otherDOI: 10.1002/uog.14845
Identifierdc.identifier.urihttp://repositorio.uchile.cl/handle/2250/135417
General notedc.descriptionArtículo de publicación ISIen_US
Abstractdc.description.abstractObjectives To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma. Methods This was a retrospective analysis of ultrasound volume datasets of 501 patients attending a tertiary urogynecological unit. All patients underwent a standardized interview including determination of St Mark's score for those presenting with AI. Tomographic ultrasound imaging (TUI) was used to evaluate the EAS and the internal anal sphincter (IAS). Results Among a total of 501 women, significant EAS and IAS defects were found in 88 and 59, respectively, and AI was reported by 69 (14%). Optimal prediction of AI was achieved using a model that included four abnormal slices of the EAS on TUI. IAS defects were found to be less likely to be associated with AI. In a multivariable model controlling for age and IAS trauma, the presence of at least four abnormal slices gave an 18-fold (95% CI, 9-36; P < 0.0001) increase in the likelihood of AI, compared with those with fewer than four abnormal slices. Using receiver-operating characteristics curve statistics, this model yielded an area under the curve of 0.86 (95% CI, 0.80-0.92). Conclusions Both AI and significant EAS trauma are common in patients attending urogynecological units, and are strongly associated with each other. Abnormalities of the IAS seem to be less important in predicting AI. Our data support the practice of using, as a minimal criterion, defects present in four of the six slices on TUI for the diagnosis of significant EAS trauma.en_US
Lenguagedc.language.isoenen_US
Publisherdc.publisherWiley & Sonsen_US
Type of licensedc.rightsAtribución-NoComercial-SinDerivadas 3.0 Chile*
Link to Licensedc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/*
Keywordsdc.subject3D/4D ultrasounden_US
Keywordsdc.subjectanal incontinenceen_US
Keywordsdc.subjectanal sphincteren_US
Keywordsdc.subjectanal sphincter traumaen_US
Keywordsdc.subjectfecal incontinenceen_US
Keywordsdc.subjecttransperineal ultrasounden_US
Títulodc.titleAnal sphincter trauma and anal incontinence in urogynecological patientsen_US
Document typedc.typeArtículo de revistaen_US


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Atribución-NoComercial-SinDerivadas 3.0 Chile
Except where otherwise noted, this item's license is described as Atribución-NoComercial-SinDerivadas 3.0 Chile