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Obstetric anal sphincter injury — DRCOG MCQ

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HardPostnatalObstetric anal sphincter injuryDRCOG

A 29-year-old woman had a third-degree tear repaired after birth. At 8 weeks she reports faecal urgency and occasional flatus incontinence. The perineum has healed and she is embarrassed to mention the symptoms. When should this patient be referred?

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Correct answer: B — Refer now to a specialist pelvic floor service

Bowel symptoms after obstetric anal sphincter injury warrant specialist pelvic floor follow-up and assessment. Waiting a year risks prolonged morbidity and missed sphincter dysfunction. The teaching point is that proactive questioning is important because patients may not volunteer anal incontinence symptoms.

Reference: RCOG Green-top Guideline No. 29; NICE NG194