ABSTRACT
Damage to the anal sphincters and the pelvic floor after vaginal deliveries is among the most common causes of surgically treatable incontinence. 1 In addition to direct mechanical tear of the anal sphincter (obstetric tear), it is now well established that vaginal delivery can induce a generalized weakness of the sphincters and the pelvic floor by compression or traction on the nerves to these muscles (“pudendal neuropathy”). 2 In modern gynecological textbooks, 3 it is generally assumed that there are only few continence problems, if the tear is immediately identified and repaired. For this reason, women with obstetric tear have often not been offered any clinical control, just as no studies seem to have addressed the question whether further vaginal deliveries might be associated with an increased risk for anorectal incontinence.
