WOMENS-HEALTH Messages for September, 1999: Re: 4th degree episiotomy

Re: 4th degree episiotomy

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Thu, 9 Sep 1999 20:54:14 -0500 (CDT)

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In reply to: Lynne: "Re: 4th degree episiotomy"

At Thu, 9 Sep 1999, Lynne wrote: >
>I also had a 4th degree tear, which went through my rectum. I was given
>very little information on this at the time of birth, other than it
>should heal. I have had some fecal incontinence, and continue to have
>lots of flatulence (gas) incontinence, which can be really embarassing.
>I did a search on medline, and it seems that if your anal spincter is
>severed, there can be some problems. I went back to see the OB that
>delivered my son, and he recommended waiting for corrective surgery
>until after we complete our family. He recommended continuing Kegel
>exercises, focusing on this area. I am not looking forward to having
>surgery, if I need that. Worse though, I dread having a tear like this
>again. It was far, far more painful than any of the contractions I had
>during a long, hard labour. Also, why did I tear so badly?

Unknown. Not being at the delivery, one cannot comment.

>What
>conditions might lead to such an extensive tear?

Very recent studies have shown that a predisposing factor for 3rd and 4th degree lacerations is an episiotomy. In other words, they occur more frequently after an episiotomy is performed than if it is not performed. Alternatively, one might think that larger babies or smaller pelves "require" episiotomies (very debatable) and therefore have a higher incidence of tears.

>I would appreciate any
>information or reassurance on this.

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York
http://www.obgyn.net/states/bios/marchbein.htm
http://www.obgyn.net/women/advisors/harveym.htm

**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 ;-)

Next message: Patti Tessler, FNP: "Re: Ovulation (Patti)"
Previous message: Patti Tessler, FNP: "Re: pregnancy or?"
In reply to: Lynne: "Re: 4th degree episiotomy"

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