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Inflammatory Bowel Disease V: Surgical Management01:21

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Here are some common surgical interventions for IBD:
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Related Experiment Video

Updated: Apr 30, 2026

Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
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Sphincteroplasty for anal incontinence.

Lorenzo Carlo Pescatori1, Mario Pescatori

  • 1Coloproctology Unit, Parioli Clinic, Rome, Italy.

Gastroenterology Report
|April 25, 2014
PubMed
Summary

Sphincteroplasty (SP) is a safe and cost-effective surgical option for moderate-to-severe anal incontinence (AI) unresponsive to conservative care. While its effectiveness may decrease over time, SP remains a valuable treatment for selected patients.

Keywords:
anal incontinencepelvic floor repairsphincter plicationsphincteroplasty

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Sphincteroplasty (SP) is the primary surgical intervention for moderate-to-severe anal incontinence (AI) refractory to conservative measures.
  • Alternative procedures like artificial bowel sphincter (ABS) and electro-stimulated graciloplasty have largely been discontinued due to high morbidity.
  • Minimally invasive options such as sacral neuromodulation and bulking agent injections are costly and have limited efficacy for severe AI.

Purpose of the Study:

  • To evaluate the efficacy and safety of Sphincteroplasty (SP) as a treatment for anal incontinence (AI).
  • To compare SP with other surgical and minimally invasive treatments for AI.
  • To identify factors influencing the outcome of SP.

Main Methods:

  • Review of existing literature on Sphincteroplasty (SP) for anal incontinence (AI).
  • Analysis of outcomes based on etiology (post-traumatic vs. idiopathic AI), patient demographics, and associated procedures.
  • Consideration of adjunctive therapies like biological meshes and pelvic floor rehabilitation.

Main Results:

  • SP demonstrates good early outcomes, particularly when sphincters are not severely denervated, though efficacy may wane over time.
  • SP is frequently indicated for post-traumatic AI and can be combined with procedures like Altemeier for rectal prolapse or to address rectal narrowing post-PPH/STARR.
  • Outcomes are generally better in males than multiparous women; post-operative morbidity is low.
  • SP is more effective in males than in multiparous women, whose sphincters are often denervated, and its post-operative morbidity is low.

Conclusions:

  • Sphincteroplasty (SP) is a low-cost, safe, and effective surgical option for selected patients with anal incontinence (AI).
  • Adjunctive use of biological meshes and pelvic floor rehabilitation may enhance SP outcomes.
  • SP remains a viable treatment choice, especially compared to abandoned or limited-efficacy alternatives.