Strengths and Limitations
This is, to our knowledge, the largest study evaluating outcomes after
transvaginal anal sphincter repair. It also boasts the longest median
follow-up duration. The use of validated questionnaires, a uniform and
specified sphincter repair technique, and analysis of results using the
validated end point of meaningful clinical difference to define post op
success improve the strength of the conclusions that are able to be
drawn from this study.
The retrospective observational nature of this study is a key
limitation. Recall bias with subsequent questionnaires and the
subjective nature of patient reported outcomes another limitation.