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Related Experiment Videos

Incontinence after lateral internal sphincterotomy: anatomic and functional evaluation

J García-Aguilar1, C Belmonte Montes, J J Perez

  • 1Department of Surgery, University of Minnesota, Minneapolis, USA.

Diseases of the Colon and Rectum
|April 29, 1998
PubMed
Summary

Anal incontinence after lateral internal sphincterotomy is linked to longer sphincterotomies and a thinner external sphincter. These anatomical changes impact continence following the procedure.

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Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Anorectal physiology

Background:

  • Lateral internal sphincterotomy is a common surgical treatment for anal fissures.
  • Anal incontinence is a potential complication following this procedure.
  • Understanding the anatomical and functional changes is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the anatomical and functional consequences of lateral internal sphincterotomy.
  • To compare patients with anal incontinence post-sphincterotomy to continent controls.

Main Methods:

  • Inclusion of 13 incontinent patients and 13 continent controls who underwent lateral internal sphincterotomy.
  • Utilized clinical evaluation, anorectal manometry, pudendal nerve terminal motor latency testing, and endoanal ultrasonography.

Related Experiment Videos

  • Comparative analysis of sphincterotomy length, pressures, sensation, nerve latency, and sphincter thickness.

    • Main Results:

    • Longer sphincterotomies were observed in incontinent patients (75% vs. 57%).
    • External sphincter thickness was reduced in incontinent patients at the sphincterotomy site and posteriorly.
    • Internal sphincter defects were wider in incontinent patients, though not statistically significant.

    Conclusions:

    • The length of the lateral internal sphincterotomy directly correlates with the development of anal incontinence.
    • A thinner external sphincter in incontinent patients may be due to preoperative abnormalities or the surgical procedure itself.