
New research examines the link between obstetric anal sphincter injuries (OASI) and long-term anal incontinence (AI). The study investigates if major OASI (grades 3c and 4) carries a higher AI risk than minor OASI (grades 3a and 3b) and if fourth-degree tears are more likely to cause AI than third-degree tears. A systematic review of 22 studies analyzed different study types and follow-up periods. The results indicate a twofold increased risk of AI with major tears compared to minor tears. Fourth-degree tears showed a potential worsening of AI symptoms but without statistical significance.
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