[OASIS: Long-Term Implications on Women's Quality of Life].

BACKGROUND

Third- and fourth-degree perineal tears, known as Obstetric Anal Sphincter Injuries (OASIS), are a significant complication of vaginal delivery, with a prevalence of 1%-7% in developed countries. Risk factors include maternal characteristics (ethnicity, age, parity), fetal factors (macrosomia, malpresentation), and obstetric factors (instrumental delivery, midline episiotomy, prolonged second stage). Damage to the anal sphincter can lead to significant medical and functional consequences, including fecal and gas incontinence, urological symptoms, chronic perineal pain, dyspareunia, and profound psychosocial effects.

OBJECTIVES

This review aims to examine the long-term effects of OASIS, focusing on functional, social, and emotional consequences on women's quality of life.

RESULTS

OASIS increases the risk of anorectal symptoms (with approximately 39% of affected women reporting anal incontinence), urinary incontinence, and persistent perineal pain. Up to 53% of women experience dyspareunia, and some avoid sexual activity altogether. Psychosocial effects include anxiety, decreased body image perception, and fear of future pregnancies. Recurrent OASIS occurs in 1%-10.7% of cases, further impacting quality of life.

CONCLUSIONS

Anal sphincter injuries following childbirth have significant physical, psychological, and social implications. Long-term medical follow-up and a multidisciplinary approach-including medical care, pelvic floor rehabilitation, and psychological support-are essential. Understanding the impact of OASIS may enhance clinical interventions and contribute to improving affected women's quality of life.