Surgical treatment of anal incontinence

The records of 18 consecutive patients operated upon for fecal incontinence between January 1983 and March 1986 were reviewed. Anterior sphincteroplasty was performed on 11 patients with direct sphincter trauma. The results were excellent in eight, fair in two and poor in one. A postanal repair was performed on seven patients, with excellent results only in two, fair in four and poor in one. The indications for surgery and the results were assessed clinically and manometrically. A careful classification of the physiologic and anatomic derangements of the anal sphincter aids in the appropriate selection of candidates for surgical treatment. In general, anterior sphincteroplasty gives good results, whereas results of postanal repairs are less satisfactory. Manometry is of some use in providing objective measurements.