Endoanal ultrasound scan

Why you need an endoanal scan

Many women get a tear in their perineum during a vaginal birth. The tear is often called a ‘perineal tear’.

The perineum is the area between the vagina and the back passage (anus).

In some women, the tear can involve their back passage and the muscles that control when they poo.

A scan allows us to see whether your perineal tear has healed. It also allows us to investigate how well the muscles in your back passage are working.

Benefits and risks of the scan

The main benefit is that it gives your doctor a clear view of your muscles. They can check that everything has healed correctly.

The scan is safe and is usually not painful.

During your appointment

Your appointment will be with a consultant surgeon who specialises in problems women may have with their bladder, bowels or reproductive organs. This consultant is called a ‘urogynaecologist’.

They will talk with you about your birth and any symptoms you have due to the perineal tear. They will answer your questions.

Your appointment will last about 30 minutes. The scan itself usually takes about 2 minutes.

You do not have to make any special preparations for your scan.

We will not give you any medicines to make you feel sleepy. This means you can carry on your usual activities afterwards, such as driving or going to work.

The scan

This is an ultrasound scan. It is similar to the scans you have when you are pregnant, but this time we scan just inside your back passage.

Most people do not find the scan painful, but it may be a little uncomfortable.

If you are allergic to latex, tell the doctor before they start the scan.  If you are allergic, they can use latex-free equipment.

A female nurse or midwife will be present throughout the scan.

• We will ask you to lie down on your back with your legs up in leg-rests.
• We will gently insert a narrow ultrasound probe into your bottom.  The probe is about the width of a finger. We will insert it about 2cm. 

The probe will allow us to examine the ring of muscle around your back passage.

We will print the scan images, which we will keep securely with your confidential medical notes.

After the scan

After the scan, we will explain the results to you before you leave.

If the scan is normal, your consultant will be able to reassure you.

If the scan shows that you need further treatment, the doctor will discuss this with you.

You will also have a chance to discuss:

• Any long-term effects of the tear and how to manage them (for example with physiotherapy).
• Whether you are likely to have similar problems in future pregnancies.

Future pregnancies

If you become pregnant again, we will refer you to our Perineal Health Clinic at around 24 weeks of pregnancy. You will see a specialist midwife at this clinic.

You will be able to discuss your previous birth and tear, and the method of birth that is best for you and your baby this time around.