[Sphincteroplasty in traumatic anal incontinence]

Abstract

Background: Anal incontinence in young women is often caused by sphincter rupture from obstetric injury or anal fistula surgery.

Material and methods: From 1992 to 1997, 17 women were operated for anal sphincter injury at Aker University Hospital, Oslo, Norway. Data were obtained retrospectively from patient files.

Results: In 13 patients, the anal incontinence was caused by obstetric injury and in four by anal fistula surgery. In all patients the external anal sphincter was repaired with overlap technique. In addition, plication of the puborectalis muscle was performed in 15 patients, perineoplasty in eight, vaginoplasty in one and operation for genital prolapse in one. Nine patients had a temporary loop sigmoidostomy. 12 of 16 patients for whom postoperative symptoms had been recorded, reported improved anal continence. Eight of these had complete anal continence, whereas four still experienced some incontinence for gas and loose stools. On clinical examination, 11 patients had normal resting sphincter pressure and voluntary sphincter contraction. Six had weak voluntary contraction; two of these had normal resting sphincter pressure.

Interpretation: Traumatic anal sphincter injuries in young patients can seriously impair anal function. Results of surgical treatment are satisfactory in most patients.