[Long-term experiences with sphincteroplasty using the Wreden-Stone method in the management of ano-rectal...

After showing the reasons for anorectal incontinence and describing the different methods of surgical treatment, the sphincterplasty technique according to Wreden-Stone is presented, as modified by the author in 1962: (1) a greater distance from the incision to the anus helps to reduce the risk of infection; (2) the strip of fascia lata winding around the anal canal is sutured to the musculus gluteus maximus on both sides. The functional results of the nine patients operated on by this method were subjectively much better than the objective results yielded by electro-myographic and manometric examinations; for only one patient were both kinds of results poor. Other methods are also discussed. At present the new treatment using smooth muscle from the large intestine is preferred, possibly combined with the sphincterplasty presented and additional use of striated muscle.