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The present study aimed to evaluate the benefit of performing anorectal studies on all women after primary obstetric anal sphincter injury (OASI) repair, rather than limiting them to symptomatic women only. Over a period of 13 years, 1348 women attended the perineal clinic. Among them, 33.7% were symptomatic, while 66.3% were asymptomatic. Among the asymptomatic women, 35% had two abnormal anorectal study results, 31% had abnormal anal manometry (AM) alone, and 9.6% had abnormal endo anal ultrasound (EAUS) alone. Furthermore, 24.7% of asymptomatic women had normal anorectal study results. The study concludes that selectively performing anorectal tests on symptomatic women would miss identifying asymptomatic women at risk of future fecal incontinence. Therefore, anorectal studies should be offered to all women following OASI, if resources allow, to provide accurate counseling about the risks of vaginal birth.
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