OBJECTIVE: To assess the relation between perineal inspection and sphincter integrity in parous @entity1 . DESIGN: Prospective observational study. SETTING: District general hospital. POPULATION: Fifty-seven consecutive parous @entity1 attending a gynaecology clinic for problems unrelated to the pelvic floor. METHODS: A detailed history of bowel function and mode of delivery obtained; the perineum inspected to determine the presence and position of @entity2318 , and anal endosonography performed. RESULTS: In 19 @entity1 with an intact perineum on inspection, endosonography showed perineal @entity2318 in five, with both perineal and sphincter @entity2318 in three. Four had urge @entity322 . Three @entity1 had a perineal tear only on inspection, but this group was too small for analysis and was discounted. Nine had an episiotomy scar only. Endosonography demonstrated perineal @entity2318 in four, and combined perineal and sphincter @entity2318 in two; one @entity1 in this group had urge @entity322 . Twenty-six @entity1 had episiotomy and perineal tears on inspection. Endosonography revealed underlying perineal @entity2318 in five @entity1 , with combined perineal and sphincter @entity2318 in 14; six @entity1 in this group had urge @entity322 and one passive @entity322 for @entity11634 . Sonographically the @entity2318 was anterior and circumferential rather than radial, and mostly left-sided, whereas on inspection episiotomy and perineal @entity2318 were right sided. CONCLUSIONS: A normal perineum on clinical examination does not exclude underlying @entity16 . The incidence of @entity16 increases significantly when an episiotomy scar is associated with a perineal tear.

Perineal examination as a predictor of underlying external anal XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'woman', 'patients'] @entity322 :: ('MESH:D014549', 'Disease') :: ['faecal incontinence', 'incontinence'] @entity2318 :: ('MESH:D002921', 'Disease') :: ['scarring'] @entity16 :: ('MESH:D009422', 'Disease') :: ['sphincter damage'] @entity11634 :: ('MESH:D005414', 'Disease') :: ['flatus']
@entity16 :: (MESH:D009422,Disease) :: ['sphincter damage']
