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Detrusor Underactivity Model in Rats by Conus Medullaris Transection
03:26

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Published on: August 28, 2020

Continence disorders after anal surgery--a relevant problem?

A Ommer1, F A Wenger, T Rolfs

  • 1Kliniken Essen-Mitte, Clinic of Surgery and Center of Minimal Invasive Surgery, Henricistrasse 92, 45136 Essen, Germany. a.ommer@kliniken-essen-mitte.de

International Journal of Colorectal Disease
|July 17, 2008
PubMed
Summary
This summary is machine-generated.

Postoperative anal incontinence is a common risk after anal surgery, influenced by factors like female sex, age, and surgical technique. Minimizing sphincter trauma is crucial due to limited repair options.

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Anorectal Disorders

Background:

  • Anal incontinence is a significant complication following anal sphincter surgery.
  • Procedures involving partial or complete sphincter division pose a notable risk.

Purpose of the Study:

  • To review the literature and assess the risk of postoperative anal incontinence.
  • To identify risk factors associated with incontinence after specific anorectal procedures.

Main Methods:

  • A comprehensive literature review was conducted.
  • The review focused on evaluating incontinence risks from anal dilatation, lateral sphincterotomy, hemorrhoidal surgery, and anal fistula repair.

Main Results:

  • Incontinence rates varied significantly across procedures: anal dilatation (0-50%), lateral sphincterotomy (0-45%), hemorrhoidal surgery (0-28%), lay open fistula technique (0-64%), and fistula plastic repair (0-43%).
  • Key risk factors identified include female sex, advanced age, prior anorectal interventions, childbirth, and sphincter-dividing surgeries.
  • Even minor procedures like speculum examination can lead to sphincter damage.

Conclusions:

  • Continence disorders are frequent after anal surgery due to multiple contributing factors.
  • Preoperative consideration of risk factors is essential for procedure selection.
  • Minimizing anal sphincter trauma and careful surgical indication are paramount, given the limited options for correcting postoperative incontinence.