Island flap anoplasty for anal canal stenosis and mucosal ectropion

Anoplasty is a technique used to treat patients with mucosal ectropion and anal canal stenosis. The island flap design has been demonstrated to have distinct advantages over the older forms of anoplasty. Few reports have addressed the long-term results of this procedure. A review of all patients undergoing island flap anoplasty between 1987 and 1992 was performed. Twenty-eight patients were identified. Indications for anoplasty included anal stenosis in 20 patients and mucosal ectropion in eight patients. Complications included five minor wound separations and one urinary tract infection with subsequent clostridium difficile enterocolitis. In-office follow-up averaged 7 months, at which time all patients were completely healed and significantly improved. Follow-up by phone was performed in 23 patients, extending their follow-up to 36 months. Based on the phone questionnaire, 91 per cent of the patients judged their symptoms as improved, and 9 per cent of patients judged their symptoms as unchanged. No patient judged their condition has worsened. Compared with the earlier forms of anoplasty, the island flap anoplasty is associated with a more simple design, less morbidity, and excellent long-term outcome. The island flap anoplasty should be the preferred design in cases of mucosal ectropion and anal stenosis.