[Chronic disorders after interventions in the anorectal area--therapeutic possibilities]

Long lasting alterations of anal function and persistent pain in a few patients after ano-rectal operations are a great therapeutic problem. Sometimes more than 6 months after LAR there are complaints about incontinence, disturbance connected to a spastic evacuation--whereas pain is more often connected with the situation after Stapler hemorrhiodectomy or other anal interventions. The therapeutic management has to consider all etiological factors and consists mainly of conservative therapy, including regulation of stool volume, slow-down of colon transit, strengthening of anal and pelvic floor muscles, regulation of co-ordination and ability of relaxation and straining, therapy of pain and--last not least--psychological support.