Long-term functional results of transvaginal anal sphincter repair for faecal incontinence; a retrospective cohort study.
Bibliographic record
Abstract
Objective We report our experience with a transvaginal approach with overlapping AS repair. The aim of this study was to evaluate long term functional outcomes. Design Retrospective Cohort study. Setting and Population Women who had undergone AS surgery for anal incontinence from July 2005 to July 2020. were included. The patients included attended the Mercy Hospital Perineal clinic a multidisciplinary team of urogynecologists and colorectal surgeons. Private patients from the surgeons in Perineal clinic were also included. Methods Overall 107 women were included in the study with a median follow up of 57.5 months. Main Outcome Measure We analysed outcomes by comparing patients St marks score difference before and after surgery. Meaningful clinical difference (MID) was set at 5 points as per previous validation studies, complications and patient demographics were recorded along with a question if they would recommend this treatment to a friend. Results An improvement exceeding the minimal clinical difference (MID) was seen in 69.3% of women. With a marked improvement in 46.5% of patients. Furthermore 70% of our patients would recommend the procedure to a friend, if they were in a similar situation. Wound infection or perineal breakdown occurred in 45% of women but did not significantly impact on outcomes. Conclusion Transvaginal AS repair is associated with significant improvements in patients’ St. Marks score. Our data shows that the long-term success rate of transvaginal AS repair may be better than previously reported in the literature using a transvaginal approach. Funding This study received no funding or sponsorship
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".