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Updated: May 24, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Long-term follow-up after anterior sphincter repair: influence of age on functional outcome
M W Warner1, O M Jones, I Lindsey
1Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK.
Aim:
Anterior sphincter repair has been advocated for women with anterior sphincter defects and faecal incontinence. There have been a number of reports of deterioration in functional outcome from anal sphincter repair over the long-term and of inferior outcomes in older patients. This study set out to examine these issues in a specialist tertiary referral unit.
Method:
Patients having a sphincter repair were identified from a prospectively collected database. The information within the database was expanded by the use of a postal questionnaire and structured review of the case notes. The questionnaire incorporated commonly used validated scoring systems as well as subjective questions.
Results:
One hundred and thirteen patients were identified, of whom 66 (58%) responded. Of these patients, four had incomplete medical notes, leaving 62 (55%) with both returned questionnaires and complete medical notes. Forty-eight (72%) patients reported subjective initial improvement in their symptoms, though only 37 (56%) believed themselves improved at long-term follow-up (median 8.8 years; range 1.1-13.6 years). Incontinence and quality of life scores mirrored these patients' subjective responses. The median age of those patients reporting a subjective improvement at long-term follow-up was 38, compared with 56 in those who thought they were not improved (P < 0.001).
Conclusions:
Outcome from anal sphincter repair deteriorates with time. Subjective outcome is worse in older patients who additionally tend to have worse incontinence scores and quality of life measures.
