Which Repair Technique Is Best for Obstetric Anal Sphincter Tears?

Unlike most other surgical sites, repaired anal sphincters have little time to heal undisturbed. The overall success rate of anal repair after obstetric tearing is <50%; thus, identifying the best technique is critical. In a randomized trial that involved 123 primiparous women who sustained third- or fourth-degree anal tears at delivery, researchers compared overlapping versus end-to-end external sphincter repair techniques. Multiparous women and those with partial tears were excluded. Investigators received training in both surgical techniques; participants and follow-up personnel were blinded to choice of procedure. At 6 months postpartum, rates of flatal and fecal incontinence were assessed, and participants underwent anal ultrasound and…