If the tear involves the rectal mucosa with an intact anal sphincter complex, it is by definition NOT a fourth-degree tear.
This has to be documented as a rectal buttonhole tear. If not recognised and repaired, this type of tear may lead to a rectovaginal fistula
If the tear involves the rectal mucosa with an intact anal sphincter complex, it is by definition NOT a fourth-degree tear. This has to be documented as a rectal buttonhole tear. If not recognised and repaired, this type of tear may lead to a rectovaginal fistula