There has been an increase in litigation due to a failure of recognition of anal sphincter tears and inappropriate management. This aims to clarify and graphically demonstrate perineal anatomy and explain the pathophysiology of anal incontinence as well as applied pharmacology. It also institutes the new recommended classification of perineal tears and describes the various anal sphincter repair techniques. The emphasis is placed on the correct post-operative management, management of a subsequent pregnancy following previous anal sphincter injury and prevention of anal sphincter tears as an important issue that has not been given due consideration previously. The authors also focus on medical/legal implications in order to introduce safe medical practice.
The book will mostly be of interest to trainees and consultants, colorectal surgeons, physiotherapists, midwives, continence advisors, labour wards and lawyers.
Anatomy of the Perineum and the Anal Sphincter.- Diagnosis of Perineal Trauma.- Repair of Episiotomy, First and Second Degree Tears.- Third and Fourth Degree Tears.- Prevention of Perineal Trauma.- Postpartum Problems and the Role of a Perineal Clinic.- Female Genital Mutilation.- Pathophysiology of Anal Incontinence.- Investigations of Anorectal Function.- Imaging of the Anal Sphincter.- Conservative Management of Anal Incontinence.- Surgical Management of Anal Incontinence Part A. Secondary Anal Sphincter Repair.- Surgical Management of Anal Incontinence Part B. Advanced Surgical Techniques.- Rectovaginal Fistulas.- Medicolegal Considerations: The British and U.S. Perspective.
From the reviews: "This book provides a comprehensive overview of all aspects related to perineal and anal sphincter trauma ... . The book represents a valuable resource for those who are involved in the management of perineal and anal sphincter trauma to further their knowledge and understanding of this emerging field and advance their skills in patient care. ... it is suitable for obstetricians, midwifes, urogynaecologists and colorectal surgeons. It should be in the library of every hospital where obstetric care is provided." (Sharif I. M. F. Ismail, International Urogynecology Journal, Vol. 20, 2009)