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Postanal repair: which patients derive most benefit?
J B Rainey1, D R Donaldson, J P Thomson
1St. Mark's Hospital for Diseases of the Rectum and Colon, London, UK.
Journal of the Royal College of Surgeons of Edinburgh
|April 1, 1990
Summary
Postanal repair surgery for anal sphincter dysfunction improved continence in 71% of patients. Success was more likely in those with complete incontinence, while age and sex did not impact outcomes.
Area of Science:
- Colorectal Surgery
- Pelvic Floor Disorders
- Gastrointestinal Physiology
Background:
- Anal sphincter dysfunction significantly impacts quality of life.
- Postanal repair is a surgical option for fecal incontinence.
- Preoperative assessment of anorectal function is crucial.
Purpose of the Study:
- To evaluate the outcomes of postanal repair in patients with anal sphincter dysfunction.
- To identify factors influencing surgical success.
Main Methods:
- Forty-two patients underwent postanal repair.
- Outcomes were analyzed based on age, sex, symptoms, and preoperative anorectal physiological tests.
- Pudendal neuropathy and anatomical measurements were assessed.
Main Results:
- Complete continence was restored in 31% of patients; 40% achieved acceptable but impaired control.
- Twelve patients (29%) remained or became totally incontinent.
- Higher success rates were observed in patients with complete incontinence preoperatively (77% improved).
- Pudendal neuropathy (present in 74%) slightly reduced success chances.
- Age and sex did not affect outcomes.
Conclusions:
- Postanal repair can improve fecal incontinence, particularly in patients with severe dysfunction.
- Preoperative presentation and presence of pudendal neuropathy are key factors influencing outcomes.
- Anatomical measurements did not correlate with surgical success.