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Published on: April 17, 2019
Functional and structural abnormalities after milligan hemorrhoidectomy: a comparison with healthy subjects
Helgi Örn Johannsson1, Lars Påhlman, Wilhelm Graf
1Department of Surgery, Falu Central Hospital, Center for Clinical Research, Falun, Sweden.
Diseases of the Colon and Rectum
|June 7, 2013
Summary
Fecal incontinence after hemorrhoidectomy may stem from sphincter injuries and impaired anal function. Careful patient selection and refined surgical techniques are crucial for preventing this adverse effect.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Fecal incontinence is a recognized complication following hemorrhoidectomy.
- Understanding the underlying causes is essential for improving patient outcomes.
Purpose of the Study:
- To investigate the etiological factors contributing to fecal incontinence post-hemorrhoidectomy.
- To identify specific physiological and anatomical abnormalities in affected patients.
Main Methods:
- Retrospective comparative study involving patients who underwent Milligan hemorrhoidectomy.
- Groups included patients with post-operative incontinence, operated controls without incontinence, and a population-based control group.
- Evaluations included bowel function questionnaires, rectoscopy, anal manometry, saline infusion tests, and endoanal ultrasound.
Main Results:
- Symptomatic patients exhibited significantly higher incontinence scores and reduced anal resting pressure.
- External sphincter injuries were identified in 20% of incontinent patients.
- Impaired ability to retain liquids was observed in patients with post-hemorrhoidectomy incontinence.
Conclusions:
- Sphincter defects and impaired anal function contribute to fecal incontinence after hemorrhoidectomy.
- The findings underscore the importance of meticulous patient selection and the development of advanced surgical approaches.
- Limitations include potential selection bias and small group sizes.
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