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

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.