EMG as a tool to detect anal sphicter recovery after severe perineal tear

Rācene, Laura and Cescon, Corrado and Začesta, Vita and Snippe, Kaspars and Rezeberga, Dace (2017) EMG as a tool to detect anal sphicter recovery after severe perineal tear. In: 2nd International Congress on the Multidisciplinary Management of pelvic Floor Diseases, December 14th-15th, 2017, Pisa, Italy.

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INTRODUCTION Surface electromyography (sEMG) in obstetrics is a novel method for detecting the activity of external anal sphincter (EAS) non invasively. Obstetric anal sphincter injuries (OASIS) occur in 1-5% of deliveries and may cause anal incontinence. DESCRIPTION A 33 years old G3P2 had vaginal delivery (cephalic presentation, labour time: 5h, weight 4.4kg) with fourth-degree tear. EMG signals were detected four days after (A) and 19 months after delivery (B). TREATMENT Two surgical repairs were performed: immediately after delivery by obstetrician and 6 months later by proctologist. Her faecal incontinence score according to FISI was 10/20 at the first (A) and 1/20 at the second measurement (B). In A she complained of faecal urgency and flatus incontinence while in B she had no complains. RESULTS The activity distribution of the EAS was extracted from EMG signals during sessions A and B. The signals were acquired at rest (left panels) and during maximal squeeze of the sphincter (right panels). The signal amplitude increased of three times in session B as compared to session A, showing a significative recovery of the sphincter muscle function. CONCLUSIONS Surface electromyography is a valuable tool to detect EAS damage and could be used to observe functional recovery.

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