4th degree tear? I thought if the sphincter was damaged at all that was a 4th degree tear.
I had a 3rd degree tear and I read a bit on it a while back and it seemed to be ok to have another VB, but a 4th degree tear is extremely risky. I forgot to talk to my Ob about it at my first appointment and it's something we need to discuss next week at my next appointment as I would also prefer not to have a c-section if I can at all avoid it.
All the best!
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29-03-2011 21:01 #11
29-03-2011 21:13 #12
degree tearing, mine was into more than 50% of my sphincter but not into the muscles around, which would have made it 4th degree.
Second degree tear: involves the perineal muscles only1
Obstetric anal sphincter injury: applies to both third- and fourth-degree tears1
Third degree tear: injury to the perineum involving partial or complete disruption of the anal sphincter complex (external [EAS] and internal [IAS])
3a <50% of external sphincter torn1
3b >50% of external sphincter torn1
3c internal sphincter torn
Fourth degree tear: involves anal sphincter and rectal mucosa.1
30-03-2011 08:34 #13
Thanks! That clarifies it. But I suppose for me if I'd had to go to theatre to actually get the sphincter repaired I wouldn't have another VB. By the way I'd be concerned about immediate faecal incontinence, not a problem 20 years later. If the sphincter is torn & doesn't work, then it doesn't work straight away. That's what scares me.
20-04-2011 07:04 #14
Looks like i'll be in the same boat as you, so confused what to do, just had my first app at Hospital and they have already put it out there for a csec (I'm 8wks) so at least I have a long time to research before making any decisions. I also had a 3rd degree into 50% of my sphincter with DS. They have told me there is only a 5% chance that I will tear again, but I'm very worried about the ramifications if it all go's wrong. What can they do to fix faecal incontinence? and being a public patient would I have a long hall to get anything fixed. I hope everything goes well for you, have you decided to birth vaginally? I am leaning towards vaginal but will really research it before I decide.
20-04-2011 07:12 #15
I talked to my Ob about it and he laughed when I asked if he recommended a c-section after 1 3rd degree tear. He thought that was unnecessary. Remember a c-section is a major operation and he thought it was quite unnecessary. He said that it had been discussed at a meeting he went to that morning with other Ob's and he was shocked that they'd offered a woman with 2 3rd degree tears a c-section when he thought a third VB would be preferable. I'm happy that he's so pro-VB. He said a 4th degree tear is a completely different matter however.
20-04-2011 07:14 #16
tear ... that doesn't mean a 5% risk of major problems, just of a tear needing suturing. I would imagine (but I'm not sure) that the risk of major problems would be MUCH smaller than that. Whereas the risk of complications from a c-section of many different types has to be higher.
20-04-2011 09:48 #17
4th degree tear, i tore into my muscle.
I have decided to have a VB as my recovery last time was approx 8wks with absolutely no problems arising from my tear so im confident i can birth with minimal tearing.
No more than 4wks to go and ill be able to update.
Good Luck Larlee.
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