Ways of repairing damage to the muscles of the back passage following tearing during a difficult vaginal birth.
Most women give birth without any significant damage to their perineums or back passages. However, occasionally, in about 1% to 4% of births, there is tearing and damage which extends to the back passage, and this can cause considerable problems for some of these women in terms of pain, incontinence and painful intercourse. For a few of these women, the incontinence can be very embarrassing and can impact significantly on their daily lives and relationships. The review of trials compared two different stitching techniques, one where the edges were overlapped and the other where they were sewn end-to-end. There was an insufficient number of women (279) in the three trials to be able to report anything with a reasonable degree of confidence. The overlap technique appeared to be better in terms of feelings of urgency and incontinence, though these data were from just one small trial. Further research is needed and this research needs to address women's views and experiences.