الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Iatrogenic injury of the anal sphincter is not so common, however when it does occur it can be a major catastrophe for the patient as well as the concerned surgeon/ gynecologist. Obstetric trauma constitutes the large bulk of sphincteric injuries seen by gynecologists as perineal tears caused during an unsupervised delivery are largely responsible for it. Improperly conducted episiotomy can also cause sphincter injury, however gynaecological procedures rarely cause sphincter injuries. Third-degree perineal rupture, which, by definition, involves an anal sphincter tear, has been reported to occur in 0.6–5.9% of vaginal deliveries. Nevertheless, it is important to appreciate that occult (i.e. not clinically evident) disruption of the anal sphincter complex occurs in approximately 30% of women during childbirth and is only identifiable on endoanal ultrasound.
Objectives: the aim of the present study was to correlate between the cause of anal sphincter injury and the size of sphincter defect in relation to the development of fecal incontinence and its severity.
Patients and Methods: Between January 2015 and December 2016, a total of 50 consecutive patients of both genders were presenting with various complaints (as anal pain, discharge, discomfort, seepage and spotting of underclothes) together with history of anal sphincter trauma due to various causes as obstetric injury during vaginal delivery, different anal procedures for many benign anal diseases as piles, fistula and fissure and finally anal sphincter injuries due to any accidental trauma. We suspect the presence of sphincteric defect in anal muscles as a result of different iatrogenic causes, and the presence of fecal incontinence as a complain may or may not be present.
Results:. Males (n=29) were more than females; they comprised 58% of total study. Patients were divided into three groups according to their age. All investigational data were compared in different age groups. The correlation between the different aetiologies of anal sphincter injury and the size of the defect found a relation to the development of fecal incontinence early in life is a matter of debate and shows a large spectrum of discussion as many factors may play a role especially if patient complain from symptoms of fecal incontinence.
Conclusion: Also data obtained from this study showed that there is a weak relation (non-significant) between the size of the defect of the anal sphincter and the development of fecal incontinence as many factors may contribute to this relationship. Our data also suggest that decrease in resting and squeeze anal pressure is associated with severity of fecal incontinence although this relationship is not strong.