Obstetric Anal Sphincter Injuries: A Urogynecologic Perspective on Detection and Diagnosis.

Obstetric anal sphincter injuries (OASIs) remain a major cause of postpartum morbidity and long-term anal incontinence. Despite advances in obstetric care, many injuries remain undiagnosed due to the limited sensitivity of digital rectal examination (DRE) and lack of imaging modalities in delivery settings. This special contribution explores the clinical, educational, and technological opportunities to improve early diagnosis, with a focus on integrating structured DRE scoring systems and emerging technologies such as impedance spectroscopy. We advocate for a shift from selective to routine postpartum screening and for urogynecology leadership in standardizing care pathways.