An incompetent repair of a severe obstetric anal sphincter injury can lead to long-term discomfort and distressing symptoms.
What is a 4th degree tear?
A 4th degree tear is the most severe form of perineal injury that a woman can experience during the vaginal birth of her child.
A 4th degree tear damages the skin and muscle from the vagina, across the perineum to the anus where it will also impact on both the external and internal sphincter muscles and the internal anal canal lining or mucosa.
If diagnosis and repair are not carried out promptly and competently, the woman can suffer a lifetime of debilitating bowel problems including wind and faecal incontinence.
Circumstances of a competent repair
A repair of any perineal injury during childbirth should take place as soon as possible after the birth. This ensures the best chance of the tissue healing effectively.
Third and fourth degree perineal tears are significant injuries and their repair needs to be carried out in an operating theatre where positioning, lighting and skilled support offer the optimum circumstances for surgery.
Appropriate medical practitioner
The repair of a severe perineal tear requires the attention of an appropriately-skilled and experienced surgeon.
This is likely to be an experienced and highly-trained obstetrician.
The nature of the repair
It is imperative that the entire extent of the injury is both identified and repaired. Where this does not occur, the woman is likely to continue to suffer difficulties with her bowel and may even develop a fistula or hole between the bowel and the vagina.
It is vital that the surgeon also uses both appropriate techniques and materials for the different aspects of the repair. The repair of the anal mucosa is likely to need different materials to the repair of the sphincter muscles.
Equally the repair of the internal sphincter muscles should be carried out separately to the repair of the external sphincter muscle, using differing techniques for the sutures.
Failure to make a competent repair
As mentioned above, a failure to repair a severe perineal tear fully or competently can lead to several life-changing symptoms such as the following:
- Wind incontinence
- Faecal incontinence or extreme urgency
- Discomfort during sexual intercourse
- Psychological distress
- The development of a fistula between the bowel and the vagina
Understandably, these symptoms can change a woman’s life in a dramatically negative way.
If the failure of a fourth degree tear repair is found to be due to the incompetence of the surgeon or an inaccurate initial diagnosis, the woman affected may be entitled to make a claim for compensation.
If you are suffering with long-term symptoms due to such a failing, contact us to discuss your situation with a specialist medical negligence solicitor who is experienced in supporting perineal tear claims.
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If you, or your family member, has suffered a birth injury tear, please call us now for free, no obligation advice on 0800 234 3300 (or from a mobile click to call 01275 334030) or complete our Free Online Enquiry.