Table 1.

Primary reasons for referral to perineal clinic

Reason for referral	Number of women (%) (N = 3254)
Obstetric anal sphincter injury (OASI)	1892 (58.1)
OASI managed at 3 months postnatally
Third-degree tear	1085
Third-degree tear 3a	422
Third-degree tear 3b	420
Third-degree tear 3c	160
Unclassified third-degree tear	83
Fourth-degree tear	62
Rectal buttonhole tear	3
OASI managed antenatally in a subsequent pregnancy	742
Perineal complications	765 (23.5)
Wound infection	236
Wound dehiscence	209
Perineal pain/dyspareunia	225
Other perineal wound problems such as haematoma/swelling/migrating stitches/labial adhesions	66
Perineal masses such as varicosities, Bartholin’s cyst	16
Extensive perineal tear (not OASIS) requiring debriefing	13
Female genital mutilation (FGM)	318 (9.8)
FGM type 1	93
FGM type 2	138
FGM type 3	35
FGM type 4	3
Patient declined examination/unclassified FGM	8
No definite FGM when examined	41
Peripartum pelvic floor problem	74 (2.3)
Urinary incontinence	43
Urogenital prolapse	30
Voiding dysfunction	1
Bowel problem (without a definite history of OASI)	136 (4.2)
Anal incontinence	90
Faecal incontinence	69
Flatal incontinence	21
Faecal urgency	44
Others: constipation, per-rectal bleeding	2
Referred for suspected missed or undiagnosed OASIS after delivery	42 (1.3)
Due to deficient perineum in postpartum examination by GP	6
Delivery with uncertain degree of perineal trauma or patient worried about third-degree tear	36
Referred for advice on mode of delivery	27 (0.8)
Perianal disease/ulcerative colitis/fistula	4
History of anal surgery, e.g., sphincterotomy, fissurectomy	7
History of fistula repair	4
History of perineal refashioning	10
Vaginal septum/vaginal hymen ring	2

FGM = female genital mutilation, GP = general practitioner, OASI = obstetric anal sphincter injury