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dc.contributor.authorGoh, Judith TW
dc.contributor.authorNatukunda, Harriet
dc.contributor.authorSingasi, Isaac
dc.contributor.authorKabugho, Emma
dc.contributor.authorBrowning, Andrew
dc.contributor.authorKrause, Hannah G
dc.date.accessioned2021-05-21T03:34:11Z
dc.date.available2021-05-21T03:34:11Z
dc.date.issued2021
dc.identifier.issn0937-3462en_US
dc.identifier.doi10.1007/s00192-021-04841-8en_US
dc.identifier.urihttp://hdl.handle.net/10072/404543
dc.description.abstractINTRODUCTION AND HYPOTHESIS: Fourth-degree perineal tear occurs in up to 0.2% of vaginal deliveries. In limited resource communities, women often deliver in local villages without facilities to repair obstetric anal sphincter injuries. These fourth-degree tears heal by secondary intention and result in total perineal defects. The aim of the study is to present medium-term follow-up of a large number of women following repair of chronic fourth-degree tear. METHODS: Repairs of chronic obstetric fourth-degree tears were undertaken during surgical camps at Kagando Hospital, Uganda and Selian Hospital, Tanzania, from December 2013 to October 2019. Women completed Cleveland Clinic Incontinence Scores (CCIS) on admission (face to face) and during the 7-year follow-up period (via telephone). RESULTS: Two hundred fourteen women had medical history and CCIS completed on admission. The mean age at presentation was 33.9 years and mean duration of the condition was 8.9 years. Over a third of women stated they suffered social abandonment because of the unrepaired fourth-degree tear. Nearly 45% of women suffered the tear during the first vaginal delivery. At 1-year follow-up, 87% of 101 women scored 0 (perfect continence) and 94% of 66 women had perfect continence at 2 years. Forty-one births occurred during the follow-up period (32 vaginal deliveries) with two recurrences of fourth-degree tear. CONCLUSIONS: Follow-up in limited resource communities is challenging. Short- to medium-term results of women who had repair of total perineal defect (unrepaired fourth-degree obstetric tears) are encouraging.en_US
dc.description.peerreviewedYesen_US
dc.languageengen_US
dc.publisherSpringer Science and Business Media LLCen_US
dc.relation.ispartofjournalInternational Urogynecology Journalen_US
dc.subject.fieldofresearchPaediatrics and Reproductive Medicineen_US
dc.subject.fieldofresearchcode1114en_US
dc.subject.keywordsFollow-upen_US
dc.subject.keywordsFourth-degree perineal tearen_US
dc.subject.keywordsTotal perineal defecten_US
dc.titleSurgical repair and follow-up of chronic 4th degree obstetric perineal tear (total perineal defect) in 2 centres in eastern Africaen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationGoh, JTW; Natukunda, H; Singasi, I; Kabugho, E; Browning, A; Krause, HG, Surgical repair and follow-up of chronic 4th degree obstetric perineal tear (total perineal defect) in 2 centres in eastern Africa, International Urogynecology Journal, 2021en_US
dcterms.dateAccepted2021-05-03
dc.date.updated2021-05-21T01:32:32Z
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.en_US
gro.hasfulltextNo Full Text
gro.griffith.authorGoh, Judith T.


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