Relation between Perineal Length and Anal Incontinence in Multiparous Women

Fecal incontinence (FI) affects activities of daily life and has been recognized as a distressing disorder. The prevalence of FI in the adult population ranges from 2 to 24%, depending upon the definition of FI used. There is no consensus on methods of classifying the symptoms and causes of FI Classification by symptom is commonly used, for example, involuntary but recognized passage of flatus, liquid or solid stool or unrecognized anal leakage. Delivery is considered the most important risk factor for FI in adult women with reported prevalence rates of 10?27% for incontinence of feces and 18?25% for flatus, at six weeks postpartum. At six months postpartum, the prevalence rates are 8?17% and 18?27%, respectively, depending on mode of delivery and perineal injury. The functional role of the perineal length has been neglected in clinical practice. Perineal length is ?distance from the posterior fourchette to the centre of the anal orifice?. A short perineal length (less than3cm) was described as being associated with weakness of the anatomical support of the pelvic viscra. However it is also known that there are considerable genetic and ethnic variations in the morphology of the pelvic floor of women The purpose of this study was to assess the relationship between perineal length measurements and anal incontinence in mulitparous women. Conclusion: In present study, we observed that anal incontinence is very common among multi-parous females who delivered vaginally especially in cases with instrumental delivery and those who had a history of obstructed labour. A significant inverse correlation was observed between perineal length and anal incontinence, meaning that in cases with short perineum i.e. less than 2.5 cm are more likely to develop anal incontinence. This could due to the fact that short perineal length is observed to be associated with weakness of the anatomical support of the pelvic viscera and hence development of anal incontinence or could also be related to its association with anal sphincter injury during child birth.