ENDOSONOGRAPHIC ASSESSMENT OF POSTPARTUM ANAL-SPHINCTER INJURY USING A 120 DEGREE SECTOR SCANNER

Obstetric injury is the principal cause of faecal incontinence in seme n. We describe use of a 120 degrees sector ultrasound probe to assess integrity of the anal sphincters in primigravid women, Eighty-eight wo men were successfully studied 6 weeks following vaginal delivery. Anal vector manometry and pudendal nerve studies were abnormal in 54 (61%) , of whom 41 (71%) were symptomatic (urgency of defaecation, incontine nce to flatus or faeces). The sonographic pattern of the anal sphincte rs described with a 360 degrees probe was reproduced. Forty-eight abno rmal scans were reported by two radiologists with a kappa statistic of 0.65, Sphincter defects were found in 11 asymptomatic women, We concl ude that anal endosonography has an important role screening for and d iagnosis of postpartum anal sphincter defects. Use of a 120 degrees se ctor ultrasound probe may prove a cost-effective means of increasing t he availability of this technique.