Overview
All new mothers who have babies at the Mercy Hospital for Women (or other hospital in our area) and have experienced a 3rd or 4th degree tear (anal sphincter tear), will be referred to the Perineal Clinic. You will receive an appointment to be seen by our team at six months after the birth.
You will then be offered a number of tests (where indicated) to check on the healing of your injury. The tests can include:
- the 3D ultrasound we use to determine how well the muscle ring around your back passage has healed
- an anal manometry test to check your anal sphincter muscles and how well they are working. This involves putting a small balloon, the size of a thermometer, into your back passage. When the balloon is inflated, you are asked to squeeze it or try to push it out. This will help to assess if your muscles are working well.
- a nerve test to see that the nerves are connected to the muscles and are working well.
These are all important tests, particularly if you plan on having more children. These tests help to plan for the next birth and can all be performed safely during pregnancy without any harm to your baby.
Follow-up care after an anal sphincter tear is extremely important. Often, you will not have any symptoms, however, problems can develop later on and the clinic can assist with preventative measures. Follow-up also allows us to identify any problems early so they can be treated more effectively.
Getting here
Find us at:
163 Studley Road
Heidelberg Victoria 3084
For more information on getting here, visit Mercy Hospital for Women .
Location details
Mercy Hospital for Women, Urogynaecology Department, Level 6
On-site signage and indicators
Look for the Urogynaecology Department signs on-site.
Opening hours
Tuesday morning, 9am-1pm (monthly)
Your appointment
What to do before
Please print and bring your appointment letter.
What to bring
- your Medicare Card
- your Health Care Card, if you have one
- your Perineal Clinic referral letter from your GP, if you were referred from outside the hospital
- any information about the delivery of your baby (birthing information), if your baby was not delivered at Mercy Hospital for Women
- information about any investigations or tests performed in relation to your birth injury, if it is available.
What to expect on the day
Throughout your experience, you will see different members of the clinic team in separate appointments. The total duration of your visit will be around 2-3 hours.
Sometimes there can be a wait between your appointments with the different members of the clinic team, which can make your total visit time longer.
More information
Team Composition
Our team in the Perineal Clinic consists of:
- a continence nurse consultant
- a physiotherapist
- a urogynaecologist
- a colorectal surgeon.
Discharge information
This will be fully discussed at your appointment.
Additional support
This will be fully discussed at your appointment.
Opportunities to be involved in research
Sometimes we invite attendees of the clinic to be involved in research. To find out more about our research, and how it can potentially contribute to better health outcomes for other new mothers, speak to one of our team during your visit to the Perineal Clinic.
Who to call if you have concerns afterwards
This will be fully discussed at your appointment.
For health professionals
The Perineal Clinic offers:
- assessment (generally at 6 and 12 months postpartum is ideal)
- diagnosis, management and treatment plans for women following obstetric anal sphincter injury.
At this multidisciplinary clinic, the patients will see a urogynaecologist, colorectal surgeon, physiotherapist and specialist nurse consultant on the same morning, requiring attendance for 2-3 hours.
Procedural information
- Assessments of third and fourth degree tears (at 3–6/12 months post delivery) will be made
- Tests include: endo-anal ultrasound assessment, endo-anal manometry and pudendal nerve latency
- A range of management options ranging from conservative management to surgical treatment and physiotherapy could be recommended
How to prepare the patient
Please provide information regarding the examination.
The patient needs to allow 2-3 hours for the appointment, due to the multidisciplinary nature of the clinic.
What/when you should refer to us
Women who sustained a third and fourth degree tear at birth.
Patients should be seen earliest at 3–6/12 post delivery.
As part of your referral, please include:
- completed referral form
- patient details : medicare details, patient address, patient phone numbers
- all antenatal and delivery notes, date of delivery
- investigations relevant to the birth injury
- whether there is need for an interpreter
- past obstetric and surgical history.
What/when you should not refer to us
- postnatal check
- postpartum women, who have had a first or second degree tear and are completely asymptomatic.
More information
Additional resources
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