What do you tell a pregnant patient with a previous third- orfourth-degree tear, for whom another vaginal delivery raises therisk of further injury? Can some women safely have a trial oflabor? Diagnose occult tears with ultrasound, advise theseexperts-and use it to assess the anal sphincters of allincontinent women.
The advice you give a pregnant patient who has suffered an anal sphincter laceration during a previous delivery can have a critical impact on her quality of life. With another vaginal birth, she's more likely to suffer a repeat anal sphincter tear and worsening symptoms of anal incontinence. Sexual dysfunction may also be at stake. Despite all this, there are no easy answers, because the best way to manage a subsequent pregnancy of a woman with a previous tear is controversial.
[Five key risk factors of severe lacerations are: (1) Midline episiotomy, (2) Forceps or vacuum delivery (vacuum being less traumatic than forceps), (3) Asian ancestry, (4) High birthweight, and (5) First birth.4,6,7]
Multicomponent intervention boosts quality of life in overactive bladder patients
March 15th 2024A recent study reveals the efficacy of a cognitive behavior therapy program, showcasing significant improvements in health-related quality of life among women grappling with moderate to severe overactive bladder.
Read More
Optimizing pain management post urogynecologic surgery with restrictive opioid protocol
March 14th 2024A recent study suggests that restrictive opioid prescribing protocols post-urogynecologic surgery are as effective as standard protocols, emphasizing the importance of multimodal analgesia and outpatient follow-up for patient satisfaction.
Read More
Study finds no increased stress urinary incontinence recurrence risk from childbirth
March 11th 2024A recent meta-analysis challenged common clinical assumptions, finding no increased risk of stress urinary incontinence recurrence or need for reoperation after subsequent pregnancy and childbirth following a midurethral sling procedure.
Read More
Cefepime–Taniborbactam outperforms meropenem in treating complicated UTI
February 15th 2024A recent study demonstrated the superior efficacy of cefepime–taniborbactam over meropenem for managing complicated urinary tract infections, suggesting a promising treatment option amid rising antibiotic resistance challenges.
Read More