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Re: internal sphincter damage with vag birth questions

From: lindsay (anonymous@obgyn.net)
Tue, 28 Mar 2000 09:27:20 -0600 (CST)

At Sun, 26 Mar 2000, Harvey S. Marchbein, M.D. wrote: >
>At Sun, 26 Mar 2000, lindsay wrote:
>>
>>At Fri, 24 Mar 2000, Harvey S. Marchbein, M.D. wrote:
>>>
>>>At Fri, 24 Mar 2000, anonymous wrote:
>>>>
>>>>What does the internal anal sphincter do?
>>>
>>>Works together with the external sphincter to remian continent of stool.
>>>
>>>>Can the external sphincter
>>>>work by itself?
>>>
>>>Yes but may be less effective. On the other hand, people with
>>>hemorrhoid surgery can get purposeful sphincterotomies (cut the
>>>sphincter so it's not intact) to reduce pressure with bowel movements
>>>and less recurrence of hemorrhoids.
>>>
>>>>or are both needed to prevent incontinece? Will a tear
>>>>get worse with time or might it get slightly better?
>>>
>>>Usually stays the same although may get worse (due to local nerve damage
>>>many feel) but can also get better after healing of an area of
>>>"sphincterotomy" as noted above.
>>>
>>>>also, why aren't
>>>>women informed that this can happen with a vaginal birth?
>>>
>>>There are a lot of things that aren't mentioned because to mention all
>>>possibilities would take a few days. :-)
>>>
>>>Dr Marchbein, I hope this isn't too stupid of a question but... How does the internal sphincter become injured without the external sphincter being injured during childbirth?
>
>Lack of distention (tearing) from the fetal head coming through the
>pelvis might cause injury to the internal sphincter and spare the
>external.
>

Is it difficult for the ob to recognize this injury if it isn't torn? How is it repaired? >
>--
>Harvey S. Marchbein, M.D. FACOG, FACS
>Great Neck, New York
>
>**Note: Opinions expressed here are for educational purposes only
>and, as such, do not constitute a physician-patient relationship.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options
>and/or interventions.
>
>**Private emails cannot be entertained due to time constraints,
>consequently no private emails will receive a response.
>
>**Thank you for your understanding ;-)
>

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