The impact of delivery on anorectal function in women with and women without anal incontinence - a prospective study

A prospective study was carried out to evaluate the effect of delivery on anal physiological parameters in anally incontinent women (n = 18) compared with continent women (n 42). Perineal plane, anal manometry, anal mucosa electrosensitivity and pudendal nerve terminal motor latency (PNTML) were all assessed at 26 weeks' gestation and at 3 and 6 months after delivery. No major effect on the incremental changes in anal physiological parameters was seen from 26 weeks of gestation to 3 months after delivery. At 26 weeks of gestation perineal plane and maximal squeeze pressure were impaired in incontinent women (P = 0.02 and P = 0.06); PNTML was impaired in incontinent women 6 months after delivery (P = 0.05). Irrespective of continence status, delivery had an adverse effect on maximal squeeze pressure and PNTML. No major incremental changes were found between incontinent and continent women after delivery. However, there was a tendency to a higher degree of impairment of maximal squeeze pressure among incontinent women. Delivery per se had an adverse effect on maximal squeeze pressure and PNTML irrespective of continence status.