What follow-up and future-delivery counselling are needed after OASIS?

Follow-up (e.g. a perineal clinic at ~6-12 weeks) assesses continence and healing; persistent symptoms warrant investigation (endoanal ultrasound, anal manometry) and referral (physiotherapy or secondary sphincter repair).

Future delivery: there is a risk of recurrent OASIS; most women who are asymptomatic with normal investigations can have a vaginal delivery, while caesarean is considered if symptomatic or with a significant sphincter defect.

Clinical relevance. Structured follow-up (with investigation if symptomatic) and individualised future-delivery counselling optimise outcomes after OASIS.

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Follow-up and future delivery after OASIS

Structured follow-up and counselling guide recovery and future birth decisions.

Follow-up

• Review (e.g. perineal/pelvic floor clinic at ~6-12 weeks) to assess continence, pain, and healing.
• Pelvic floor physiotherapy.
• If symptoms persist (incontinence) - investigate with endoanal ultrasound and anal manometry, and refer for specialist management (further physiotherapy or secondary sphincter repair).

Future delivery counselling

• There is a risk of recurrent OASIS in a subsequent vaginal delivery.
• Asymptomatic women with normal endoanal ultrasound/manometry can usually have a vaginal delivery.
• Caesarean delivery is considered for women who are symptomatic (incontinence) or have a significant sphincter defect on investigation.
• Shared, individualised decision-making.