CArE for OAsI Study: Care Pathways and Anorectal Evaluation for OASI Associated Incontinence
Trial Parameters
Brief Summary
The aim of this study is to ascertain which pathways currently exist in relation to the follow up of patients with obstetric anal sphincter injury related incontinence. This is particularly important as afflicted individuals may not readily volunteer information about their symptoms and struggles and need to be safeguarded by the presence of robust care pathways that ensure adequate follow up and care provision. As obstetric anal sphincter injuries have been associated with increased litigation rates over the years, positive interventions towards patient care will help ameliorate the financial burden that litigation carries on the National Health Service. It is noteworthy of mention that perineal injury, in itself, may not be suggestive of negligent care and is a recognized complication of vaginal delivery. However, a failure to adequately manage the injury may carry medicolegal implications.
Eligibility Criteria
Part 1 of Study Inclusion Criteria: * • Fertile women ≥ 18 years and ≤50 who have developed OASI related incontinence following a vaginal delivery in the preceding five years (N.B. the average age of menopause in the UK is 51) * Tertiary referrals to the specialist perineal clinic as well as patients who have 'slipped' through the existing pathway of referral * Capacity to consent (able to comprehend and retain information, weight out the risks and benefits and communicate a decision back to the researcher) * English-speaking and able to comprehend and read English * Primiparous/multi-parous Exclusion Criteria: * • Women who are unable to consent or who have severe mental illness, as decided by the screening clinician * Patients who do not speak, read or understand English * Patients with an alternative documented cause for their FI that is non obstetric trauma related. * Post-menopausal women who may develop late onset symptoms of incontinence relating to a previous OASI (clinically s