Anal Incontinence: Relationship to Pregnancy, Vaginal Delivery, and Cesarean Section

ObjectiveTo review the current literature concerning anal incontinence (AI), pregnancy, and route of delivery.FindingAI is the involuntary loss of flatus, liquid, or solid stool that is a social or hygienic problem. AI has been reported in 5% to 26% of women during the first year following vaginal delivery. AI is strongly associated with occult and overt sphincter lacerations and operative vaginal delivery. The role of pregnancy itself and the impact of cesarean delivery on AI are unclear. Elective cesarean section has not been shown to decrease the risk of AI.ConclusionThe majority of current studies lack the power, matched controls, and long-term follow up to make recommendations concerning the mode of delivery and prevention of AI. The natural history of AI and development of symptoms as women age also remains unclear.