Comparison of Surgical Outcomes of Obstetric Anal Sphincter Injury Repairs According to Surgeon Specialty: A Retrospective Cohort Study

INTRODUCTION: This study aimed to compare surgical outcomes, complication rates, and continence results of obstetric anal sphincter injury (OASIS) repairs performed by obstetricians-gynecologists and general surgeons.
METHODS: In this retrospective cohort study, data from 356 patients who underwent primary OASIS repair between May 2020 and October 2024 at a tertiary center were analyzed. Patients were divided into two groups based on the surgeon’s specialty: obstetrician-gynecologists (n=272) and general surgeons (n=84). Demographic features, obstetric factors, surgical techniques, postoperative complications, and continence outcomes were compared. Logistic regression analysis adjusted for age and body mass index (BMI) was performed to assess the independent effect of surgeon specialty on complication risk.
RESULTS: No significant differences were found between the groups in terms of age, BMI, gravidity, parity, neonatal birth weight, or tear severity (p>0.05). However, general surgeons more frequently used the end-to-end repair technique, whereas obstetrician-gynecologists preferred the overlap method (p<0.05). Postoperative infection and bleeding rates were significantly lower in the obstetrician-gynecologist group (p<0.05). Logistic regression analysis revealed that the risk of any postoperative complication was approximately four times higher in repairs performed by general surgeons compared to obstetrician-gynecologists (OR = 3.54; 95% CI: 2.05–6.13; p<0.001).
DISCUSSION AND CONCLUSION: Surgeon specialty significantly influences early postoperative complication rates in OASIS repair. Structured surgical training programs, simulation-based workshops, and multidisciplinary protocols are crucial to improve outcomes, especially for general surgeons involved in obstetric perineal trauma repair.

Keywords: OASIS, Obstetric Anal Sphincter Injury, Perineal Repair, Surgeon Specialty, Postoperative Complications, Continence Outcomes