English

Abstract

Obstetric anal sphincter injuries (OASIS) can occur either spontaneously during vaginal delivery or secondary to episiotomy. They are the most common cause of anal incontinence in young women. A meta-analysis estimated a 26% risk of postpartum anal sphincter defects. Accurate diagnosis and proper management of sphincter injuries are crucial to preventing anal incontinence and are now an essential part of obstetric training.

Sultan's grade 4 injuries involve complete rupture of the anal sphincter, also called "traumatic cloaca". The repair is always surgical. Different techniques have been described, but none proved to be superior to the other.

We present the case of a 23-year-old primiparous patient, BMI 25, with a postpartum traumatic cloaca.

Surgical repair was performed immediately. The Overlapping technique was used, with good postoperative evolution. Hospital discharge was granted after 4 days, with subsequent controls. One year after control, the patient presented complete continence, without complications.