PREGNANCY-BIRTH Messages for March, 2000: Re: internal sphincter damage with vag birth questions

Re: internal sphincter damage with vag birth questions

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Tue, 28 Mar 2000 21:18:25 -0600 (CST)

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In reply to: lindsay: "Re: internal sphincter damage with vag birth questions"

At Tue, 28 Mar 2000, lindsay wrote: >
>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?
>>

Injury would be a tear and it would be repaired like any other torn muscle - dissolvable sutures reapproximating the two sides to maximize strength of muscle and continence.

--
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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