Long-term results after anterior sphincteroplasty for anal incontinence

To assess the long term incontinence and quality of life (Qol) results after elective anterior sphincteroplasty for anal incontinence.

Short and long term follow-up included respectively 28 and 25 of the 29 patients who were operated between 1989 and 1998 in our institution. Qol was assessed with gastro intestinal quality of life index (GIQLI). Incontinence was graded according to Parks score supplied with St Mark's score at long term follow-up.

21 (73%) patients had a history of obstetric sphincter tears. Mean age at operation was 45 years (range 6-77). Median time from operation to short term follow-up was 26 months (mean 38 months, range 2-113) and 84 months (mean 105, range 74-185) to long term follow-up. At short term follow-up 19 of 28 patients (68%) were continent for stool compared with nine of 25 patients (36%) at long term follow-up. Nine of 17 (53%) who were continent for stool at short term follow-up remained continent for stool at long term follow-up. Patients with a history of obstetric sphincter tear had less severe incontinence at long term follow-up compared to women with other causes of incontinence (St. Mark's score 8 and 16 respectively, p = 0,015). Patients with no incontinence or gas incontinence only, had higher quality of life score at both follow-ups than those who where incontinent for stool (p = 0,007 and p= 0,014 respectively).

More than half of the patients remained continent for stool at long term follow-up. Continence for stool was associated with high Qol score.