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Almost 5.7% primiparous women who deliver vaginally, suffer from obstetric anal sphincter injury and OASIS is an alternative term used for this condition. Perineal injury during childbirth is a common event and commonly seen morbidity in severe cases such as third-and-fourth degree perineal tears.
These injuries involve the anal sphincter complex and, in more severe cases, anal mucosa. Various types of morbidity seen in this group of patients are wound breakdown and perineal pain, devastating impacts on the quality of lives of young, otherwise healthy women. While long-term morbidity includes subsequent loss of bowel control in women.
Though episiotomy is traditionally given to prevent perineal trauma in the second stage, episiotomy is found to be a significant risk factor for causing severe perineal trauma. Early detection and proper management in the form of OASIS and episiotomy repair is an important step to prevent short-term, long-term morbidity & mortality.
This can be achieved by accurate clinical assessment, including an inspection of the perineum and a digital rectal exploration and should be adherent to evidence-based guidelines established by ACOG and RCOG.

1. Provide basic knowledge of Anatomy and Physiology of the pelvic floor, perineum and anal sphincters thereby helping them for appropriate diagnosis.
2. Provide knowledge on various techniques of episiotomy repair by video demonstration.
3. Improve the skill of OASIS repair by video demonstration.
4. Demonstrate various preventive methods for perineal trauma.
5. Skill improvement for management of delayed and secondary sphincter repair.

How to do early and appropriate diagnosis of obstetric and anal sphincter injuries
Updates in techniques of obstetric and anal sphincter injuries repair
Management of delayed and secondary sphincter repair
Indications & techniques of Episiotomy repair.

Obstetrician and Gynaecologist, Oncologist, Onco-surgeon, General practitioners and Radiologist

Dr. Ranee Thakar

Ranee Thakar is a Consultant Obstetrician and Urogynaecologist at Croydon Health Services NHS Trust and Honorary Senior Lecturer at St George’s University of London.Ranee has been Vice President of Global Health at the RCOG since December 2019, is co-chair of the College’s Race Equality Taskforce and has been a member of the RCOG Council since 2016. She is past President of the International Urogynecological Association and leads the national obstetric anal sphincter injuries (OASI) Care Bundle Project. Regionally, Ranee leads the Perinatal Pelvic Health Project and Urogynaecology network for South-West London, developing multi-disciplinary collaboration with urologists, midwives, physiotherapists, nurses and GPs.

Dr. Dharmesh Kapoor

Dr. Dharmesh S Kapoor, MD (BOM), FRCOG (ENG) is a Consultant Obstetrician, Gynaecologist and Urogynaecologist currently practicing at Oma Hospital, Chembur- Mumbai. Until recently, he was Consultant Gynaecologist and Urogynaecologist at the Royal Bournemouth Hospital, United Kingdom. He has trained extensively in England and the United States. He is an expert in the treatment of recurrent urinary infections in women, abdominopelvic pain, urinary urgency and incontinence, weak bladders, and urodynamic testing. He is the only qualified doctor in Mumbai to perform endo-anal ultrasound for problems like bowel urgency and bowel incontinence. He is a specialist in the surgical treatment of prolapse of the vagina and uterus and has performed more than 1,000 pelvic floor and incontinence operations.

Abdul Sultan

Abdul H. Sultan is a Consultant Obstetrician and UroGynaecologist at Croydon University Hospital and Honorary Reader at St George's University of London. He completed his basic medical training (MB.ChB) in South Africa prior to moving to the United Kingdom in 1984 and obtained the MRCOG degree in 1990 (FRCOG 2003). He subsequently took up a research post under the supervision of Prof Chris Hudson at St Bartholomew’s and Homerton Hospitals and Professors Clive Bartram and Mike Kamm at St Mark's Hospital. The research involved studying the effects of childbirth on the pelvic floor and anal sphincters. This led to a landmark paper published in the New England Journal of Medicine and to a Doctorate (MD). His pioneering work highlighted the deficiencies in training of doctors and midwives in detecting and repairing injuries to the perineum and anal sphincter after childbirth resulting in incontinence and pelvic floor and perineal dysfunction. He is currently a consultant in a busy tertiary referral urogynaecology department at Croydon University Hospital, with a large clinical workload, dealing with complex urogynaecological problems including tertiary referrals, teaching medical students, training junior doctors and undertaking clinical research. The unit is recognised for subspecialty training in urogynaecology and runs an active research programme.

Dr. Madhusudhan Naidu

Dr. Madhusudhan Naidu has 15 years of experience in the field of obstetrics and gynecology. After completing post graduation from Karnataka Medical College, Hubli, he worked as a senior resident in obstetrics and gynecology at Christian Medical College, Vellore for 2 years. He then moved to UK in 2004 and was trained in various busy district general and University hospitals such as Croydon University and King’s College Hospital. He obtained MRCOG and is now a member of Royal College of Obstetricians and Gynaecologists. He has completed his CCT and undertook further 3 years sub specialisation training programme in urogynaecology under well renowned urogynaecologists (Miss Ranee Thakar and Mr. Abdul Sultan) in UK. Following this training, he is a Royal College (London) accredited urogynaecology subspecialist.

Module 1: Anatomy and Physiology of the pelvic floor, perineum and anal sphincters.
Module 2: Episiotomy: Indications and technique.
Module 3: Video on episiotomy repair Diagnosis of anal sphincter injuries.
Module 4: Video on diagnosis-Repair of Obstetric Anal Sphincter Injury.
Module 5: Video on OASI repair Management of delayed and secondary sphincter repair.
Module 6: Prevention of perineal trauma - New Evidence & Recommendations.

Who can take this course?

General practitioner, obstetricians and gynaecologist, Radiologist, Paediatricians.

When will I have access to the lectures and assignments?

As soon as you enroll to this course series, you’ll have access to all videos, quizzes and assignments (if applicable).

What is the course format?

The course is organized into 3 modules and includes additional resources specific to each one. Registration for the course is always open and participants may begin the course at any time.

How much does it cost?

INR 5000.

When will I have access to the lectures and assignments?

Once you enroll, you have access to the first module, Peer review assignments become available once your session has officially begun.

What background knowledge is necessary?

Yes, some background knowledge pertaining to the subject will be necessary. This course is directed towards MBBS/MD doctors.

Is work experience necessary?

Yes, relevant work experience is beneficial as the courses on docmode.org help practicing and aspiring healthcare professionals.

Masterclass Obstetric Anal Sphincter Injuries (OASIS)

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Dr. Ranee Thakar

Dr. Dharmesh Kapoor

Abdul Sultan

Dr. Madhusudhan Naidu

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