The influence of childbirth on Obstructive Defecation Syndrome
Research type
Research Study
Full title
ODYSSEY: The effect of pregnancy, delivery, perineal trauma and in particular obstetric anal sphincter injury (OASI) on Obstructive Defecation Syndrome (ODS)
IRAS ID
245719
Contact name
Joanne Sentance
Contact email
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Obstructive defecation syndrome (ODS) is characterised by chronic constipation and an abnormal defecation process. ODS has a significant impact on quality of life and detection and management are imperative to improving long-term outcomes for women.\nObstetric anal sphincter injuries (OASIS) are a complication of childbirth occurring in up to 8% of vaginal deliveries. OASIS can lead to problems with bowel control and women attending our perineal clinic often report symptoms of pain, difficult and incomplete evacuation. Currently there is no literature investigating the effect of obstetric anal sphincter injury (OASI) on the development of ODS. \nThis study investigates the incidence of ODS during pregnancy and post-natally following different modes of delivery and extents of perineal trauma in particular OASIS. This will be conducted using two symptom-based questionnaires. Clinically relevant data will also be collected about the mode of delivery, extent of perineal trauma and repair method, BMI, ethnicity and age of the patient to identify risk factors for ODS. \nThe primary aim is to determine whether there is a difference in the mean ODS score between women sustaining OASIS vs women without anal sphincter injury. A second group will be recruited from the perineal clinic, a routine clinic for women sustaining OASIS at delivery to optimise information about ODS development. \nDepending on symptoms women may be invited to participate in additional investigations including defecating proctograms (x-rays), neurophysiology testing, and if external funding is secured, MRI Neurography to identify an underlying anatomical or nerve related injury cause for ODS.\nBased on retrospective data and an OASIS prevalence of 5% a sample size of 300 women is required comprising 285 in the non-OASIS group and 15 in the OASIS group to show a mean difference in scores. Due to the potential drop-out rate post-natally we aim to recruit 500 women.
REC name
West of Scotland REC 3
REC reference
18/WS/0154
Date of REC Opinion
29 Aug 2018
REC opinion
Favourable Opinion