{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T11:10:05Z","timestamp":1754046605094,"version":"3.41.2"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To report on national clinical practice in relation to the post\u2010partum management of patients with obstetric anal sphincter injury (OASI)\u2010related incontinence in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a cross\u2010sectional, observational study of maternity units in the National Health Service (NHS). Data were collected using a survey that was distributed, via the British Society of Urogynaecologists (BSUG), Royal College of Obstetricians &amp; Gynaecologists (RCOG) and the NHS England email directory, to consultant obstetricians and urogynaecologists involved in the post\u2010partum care of patients with OASI. A descriptive, thematic analysis of the data was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and twenty\u2010six responses were included in the final analysis (estimated response rate~2.5%). The majority of respondents routinely conducted clinical and rectal examinations at the post\u2010partum clinic visit (81.7% and 57.6%, respectively) but they were less likely to use an objective screening tool for incontinence (36.5%). Respondents were more likely to refer patients for anorectal studies if they were symptomatic (72.6%) rather than asymptomatic (34.2%); the diagnostic modality of choice was endoanal ultrasound (70%) rather than manometry (0%). Almost 80% of respondents discharged asymptomatic patients within 3\u2009months. All respondents referred symptomatic patients for physiotherapy; 87% were seen within 6\u2009weeks. Although 70% would discuss complicated cases at a multidisciplinary team meeting (MDT), there was a wide variation in which speciality would follow up the patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates variability in clinical practice that does not entirely appear to be evidence driven. A nationally endorsed pathway, embedded within Perinatal Pelvic Health Services, could standardize access to expertise and enable benchmarking. A prospective multicentre audit is recommended to compare maternal functional outcomes in units that use these standardized pathways versus those that do not.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.70140","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T22:54:46Z","timestamp":1751064886000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Care pathways and anorectal evaluation for obstetric anal sphincter injury\u2010related incontinence: A <scp>UK<\/scp> survey of obstetricians"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3986-4412","authenticated-orcid":false,"given":"N.","family":"Elsaid","sequence":"first","affiliation":[{"name":"St Mark's the National Bowel Hospital  London UK"},{"name":"Imperial College London  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. 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