An obstetric sphincter injury is supposed to be repaired shortly after the birth. If for any reason this does not happen, a patient may need to undergo surgery at a later date. This is called a secondary sphincter repair or sphincteroplasty.
Outcome after secondary repair
A secondary sphincter repair is not as effective as a primary repair (meaning one that is carried out shortly after the injury has occurred).
Of those women who have a secondary sphincter repair, around 60% of women will report an unacceptable outcome five years post-surgery.
Of the 40% who report an acceptable level of continence five years after a repair, many will unfortunately find that their condition deteriorates with age.
This is due to the effects of the menopause where a reduction in the oestrogen level causes the loss of elasticity in the tissues. The ageing process also leads to progressive denervation of the sphincter muscles and pelvic floor. A combination of these factors can lead to worsening continence in old age.
Further treatment after sphincter repair
These circumstances may require further conservative treatment by means of constipating agents, the use of further pelvic floor exercises or the use of rectal irrigation devices. These are designed to keep the rectum empty and can lead to an improvement of symptoms.
If conservative treatment fails then consideration will have to be given to alternative surgical treatment. Currently this would involve sacral neuromodulation. There are, however, several other potential treatments for faecal incontinence that are being evaluated. The treatment options available may therefore change in time, and clearly the situation will be very different in 20 to 30 years’ time.
Missed tear compensation claim
If your sphincter injury was not repaired in the period after giving birth, you will of course want to know what treatment is now available. You may also be wondering why you have been left in this situation.
The fact is that perineal tears, including those that involve the sphincter muscles, should be repaired shortly after the delivery. A failure to do so amounts to a breach in the duty of care. The patient concerned will consequently be eligible to pursue a claim for compensation.
Talk to a solicitor
If your perineal tear was not initially diagnosed and repaired, leaving you with ongoing complications, you are the victim of medical negligence. To find out what you can do, please get in touch with our legal team today.