[Therapy of anal incontinence from the surgical viewpoint]

Surgery of anorectal incontinence includes two essential forms: the traumatic lesion of the sphincter and the spontaneous proceeding incontinence. Both forms of incontinence require a surgical therapy that is concerned to its cause. Fresh traumatic lesions of the sphincter can be reconstructed directly by primary suture, elder, cicatrized lesions can be treated by doubling the sphincter or single reconstruction of internus and externus. In spontaneous proceeded incontinence, that requires a very detailed preoperative diagnostic, "post anal repair" and pubo-rectalis-plasy are therapeutic possibilities. By these surgical methods in most patients with incontinence it's possible to avoid a colostomy.