The impact of a nationwide hands-on workshop on the diagnostic rates and management of obstetrical anal sphincter Injuries in Israel

S. Ginath*, M. Alcalay, M. Ben Ami, Y. Bssam Abbas, G. Cohen, A. Condrea, H. Feit, H. Gershi, R. Gold, E. Goldschmidt, D. Gordon, A. Groutz, Y. Lavy, G. Levy, L. Lowenstein, N. Marcus, A. Padoa, A. Samuelof, A. Tevet, A. Y. Weintraub

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: The aim was to evaluate the influence of a half day, hands-on, workshop on the detection and repair of obstetric anal sphincter injuries (OASIs). Method: Starting in February 2011, hands-on workshops for the diagnosis and repair of OASIs were delivered by trained urogynaecologists in departments of tertiary medical centres in Israel. The structure of the hands-on workshop resembles the workshop organized at the International Urogynecological Association annual conferences. Participants included medical staff, midwives and surgical residents from each medical centre. We collected data regarding the rate of OASIs, 1 year before and 1 year following the workshop, in 11 medical centres. The study population was composed of parturients with the following inclusion criteria: singleton pregnancy, vertex presentation and vaginal delivery. Pre-viable preterm gestations (< 24 weeks), birth weight < 500 g, stillborn, and those with major congenital anomalies, multifoetal pregnancies, breech presentations and caesarean deliveries were excluded from the analysis. Results: In the reviewed centres, 70 663 (49.3%) women delivered prior to the workshop (pre-workshop group) and 72 616 (50.7%) women delivered following the workshop (post-workshop group). Third- or fourth-degree perineal tears occurred in 248 women (0.35%) before the workshop, and in 328 (0.45%) following the workshop, a significant increase of 28.7% (P = 0.002). The increase in diagnosis was significant also in women with third-degree tears alone, 226 women (0.32%) before the workshop and 298 (0.41%) following the workshop, an increase of 28.3% (P = 0.005). Conclusion: The detection rate of OASIs has significantly increased following the hands-on workshop. The implementation of such programmes is crucial for increasing awareness and detection rates of OASI following vaginal deliveries.

Original languageEnglish
Pages (from-to)1677-1685
Number of pages9
JournalColorectal Disease
Issue number11
StatePublished - Nov 2020


  • OASI
  • Obstetric anal sphincter injury
  • hands-on workshop
  • medical education


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