 |
Case Report
Treating external anal sphincter injury with platelet-rich plasma to resolve post-partum fecal incontinence caused by birthing trauma: A case report
1 MD, Founder, Musculoskeletal Medicine, Regenerative Pelvic Institute, Washington, DC, USA
2 PT, DPT, PRPC, MTC, Founder, Pelvic Floor Physical Therapy and Manual Therapy, ThriveA-gain Physical Therapy & Wellness, Washington, DC, USA
3 BA, Clinical Research Associate, Regenerative Medicine, Orthobiologics Research Initiative Inc, North Bethesda, MD, USA
4 BS, Clinical Research Associate, Regenerative Medicine, Orthobiologics Research Initiative Inc, North Bethesda, MD, USA
Address correspondence to:
Sanjay Mahadevan
1145 19th Street NW, Washington, DC 20036,
USA
Message to Corresponding Author
Article ID: 100194Z08IS2025
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Siddiqui IJ, Probst J, Mahadevan S, Desronvilles R, Dineen KJ. Treating external anal sphincter injury with platelet-rich plasma to resolve post-partum fecal incontinence caused by birthing trauma: A case report. J Case Rep Images Obstet Gynecol 2025;11(1):22–28.ABSTRACT
Introduction: Pelvic floor disorders following traumatic vaginal delivery of infants are common, with fecal incontinence (FI) as a clinically significant symptom. Injury to the external anal sphincter (EAS) is the likely culprit for this FI. Current standard-of-care options fall short of preventing long-term side effects and providing sustained quality-of-life improvements.
Case Report: We present the case of a 41-year-old female with a history of pelvic floor dysfunction and FI following childbirth. She presented to an outpatient regenerative medicine clinic and pelvic floor specialty clinic 15 months after symptom onset for a clinical evaluation and treatment due to difficulties with holding stool and activating her pelvic floor. Palpation-based pelvic mapping (PM), confirmed by trans-perineal pelvic ultrasound determined that the patient had significant injury to the EAS as well as damage to other pelvic floor soft tissues. The patient elected to undergo 2 rounds of ultrasound-guided platelet-rich plasma (PRP) injections directly to her EAS and other pelvic floor injuries. The patient completed 2 different validated patient-reported outcome-measure (PROM) surveys at various time intervals in her recovery to quantify her progress. Ultrasound images, PROM survey scores, and patient symptoms all indicated marked improvement and resolution of FI from baseline.
Conclusion: This case demonstrates the application of PRP to heal a significant EAS lesion, resulting in a resolution of the patient’s FI. While more studies are required, PRP may potentially pose a safe and effective treatment with a lower risk profile than surgical alternatives for treating EAS injuries to resolve FI.
Keywords: Fecal incontinence, OASIs, Pelvic floor disorders, Platelet-rich plasma
SUPPORTING INFORMATION
Acknowledgments
The authors would like to acknowledge Jennifer Paul, Coco Sparks, and Jenean Finley for their unique contributions to the field and this work.
Author ContributionsImran J Siddiqui - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Jessica Probst - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sanjay Mahadevan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Roosevelt J Desronvilles - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kyle J Dineen - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Imran J Siddiqui et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
