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Internal anal sphincter repair

A M Leroi1, M A Kamm, J Weber

  • 1St. Mark's Hospital, Harrow, Middlesex, UK.

International Journal of Colorectal Disease
|January 1, 1997
PubMed
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Repair of the internal anal sphincter for fecal incontinence yielded disappointing results. While some patients reported mild symptom improvement, none achieved full continence, and sphincter defects persisted post-surgery.

Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Persistent anal incontinence can significantly impact quality of life.
  • Surgical intervention targeting the internal anal sphincter is one approach to manage incontinence.
  • Previous repairs may leave patients with ongoing symptoms and sphincter defects.

Purpose of the Study:

  • To evaluate the efficacy of internal anal sphincter repair in patients with persistent anal incontinence.
  • To assess clinical, manometric, and radiological outcomes following sphincter repair surgery.

Main Methods:

  • Study included five patients with post-surgical anal incontinence.
  • Evaluated symptoms, anorectal manometry, and anal endosonography before and after repair.

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  • Assessed outcomes including continence, sphincter pressure, and anatomical defects.

    • Main Results:

    • Three patients reported subjective improvement, but all had persistent symptoms; none achieved full continence.
    • Anorectal manometry showed increased pressures in three patients, but only one was normalized.
    • Post-operative anal ultrasound revealed persistent internal sphincter defects in all patients and unsuspected external sphincter defects in two.

    Conclusions:

    • Internal anal sphincter repair alone for persistent anal incontinence after surgery has disappointing clinical outcomes.
    • Manometric and radiological findings suggest limited functional and anatomical restoration.
    • Further investigation into alternative or combined surgical strategies may be warranted.