Treatment of acquired anal incontinence

Outline of the pathophysiological basis of defaecation is given and also classification of anal incontinence. In the operative technique described the defective sphincters are replaced by drawing down the puborectal muscle, i.e. by a displacement of the muscle caudally. This method is simple, physiological, and appears superior to all others. It has been used in 15 patients, in 14 of whom it was completely successful. The lesion had been present in these patients for 1-13 years. Their average age was 40. There is a fundamental distinction between congenital and acquired anal incontinence. The congenital lesions fall within the domain of paediatric surgery, and will not be discussed.