{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T09:59:03Z","timestamp":1775815143327,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore the differences in assessing obstetric anal sphincter injuries (OASI) between transperineal ultrasound (TPUS) and endoanal ultrasound (EAUS) and test relationships between ultrasound findings and anal incontinence (AI) symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A group of 196 women with a history of vaginal delivery was recruited. OASI was detected in a set of 5 slices by EAUS and 8 slices by TPUS. OASI grading was performed on TPUS rules and EAUS rules. A \u201csignificant sphincter defect\u201d was diagnosed by TPUS and EAUS using \u201c2\/3 rules.\u201d Symptoms of AI were determined using the St Mark's Incontinence Score (SMIS). Ultrasound findings were compared between the two methods and correlated with symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 196 women, 29 (14.8%) suffered from AI with a mean SMIS of 12.1\u2009\u00b1\u20094.5, and 70 (35.7%) women with a mean age of 57\u2009years had suspected OASI on imaging. Twenty\u2010one (10.7%) \u201csignificant defects\u201d were diagnosed by TPUS and 24 (12.2%) by EAUS. OASI Grades on TPUS had good agreement with EAUS rules (<jats:italic>k<\/jats:italic>\u00a0=\u00a00.70, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Logistic regression analysis showed that OASI Grade on imaging and \u201csignificant sphincter defects\u201d seen on both forms of imaging were associated with AI symptoms. The odds ratio was 46 and 38 for \u201csignificant defects\u201d on TPUS and EAUS, and 14 and 7 for OASI 3b+ on TPUS and EAUS in predicting AI, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>\u201cSignificant defects\u201d diagnosed by EAUS or TPUS and OASI Grade 3b+ predict AI symptoms. The diagnostic performance of endoanal and exoanal ultrasound (EAUS and TPUS) appear to be very similar.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16221","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T11:56:31Z","timestamp":1678794991000},"page":"2031-2038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Assessing Obstetric Anal Sphincter Injuries"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7185-292X","authenticated-orcid":false,"given":"Baihua","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Ultrasound Diagnosis, The Second Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinbo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Drug Evaluation and Adverse Drug Reaction Monitoring Drug Administration of Hunan Province  Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingchun","family":"Tang","sequence":"additional","affiliation":[{"name":"SonoScape Medical Corporation  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5630-6912","authenticated-orcid":false,"given":"Yuyang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Diagnosis, The Second Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yalin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Diagnosis, The Second Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3283-888X","authenticated-orcid":false,"given":"Lieming","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Diagnosis, The Second Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Peter","family":"Dietz","sequence":"additional","affiliation":[{"name":"Sydney Urodynamic Centres  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-84628-503-5_4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05878-8"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12481"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-021-05051-y"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02156260"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06125-8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.04.009"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14981"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb12056.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10396-012-0369-4"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14246"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20390"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40477-020-00485-4"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13701"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04274-9"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24957"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7512"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22011"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-0908-8"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14845"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-008-0784-7"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-022-05341-z"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23553"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12948"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-018-1895-x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03954-5"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15915"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001297"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04347-9"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14656"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03887-z"}],"container-title":["Journal 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