title: Randomized trial of internal anal sphincter plication with pelvic floor repair for neuropathic fecal incontinence.
abstract: OBJECTIVE
  This study was designed to examine the role of adjuvant internal anal sphincter plication in women with neuropathic fecal incontinence undergoing pelvic floor repair.
  
  
  METHODS
  We completed a randomized trial with symptomatic and physiologic assessment before and after surgery.
  
  
  RESULTS
  There was no symptomatic advantage of adding internal sphincter plication; the mean improvement of functional score was 3.61 +/- 1.82 (standard deviation; P < 0.01) following pelvic floor repair alone compared with 2.80 +/- 1.66 (standard deviation; P < 0.01) when adjuvant internal and sphincter plication was added. The addition of internal sphincter plication was associated with a significant fall in maximum anal resting and squeezing pressures (P < 0.01).
  
  
  CONCLUSIONS
  Addition of internal sphincter plication is not advised in women with neuropathic fecal incontinence treated by pelvic floor repair.
authors: University Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom.
authors: K I
authors: KI
authors: Deen
authors: D
authors: D
authors: Kumar
authors: J G
authors: JG
authors: Williams
authors: E A
authors: EA
authors: Grant
authors: M R
authors: MR
authors: Keighley
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome