Randomized trial of internal anal sphincter plication with pelvic floor repair for neuropathic fecal incontinence.
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.
Deen
K I
KI
University Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Kumar
D
D
Williams
J G
JG
Grant
E A
EA
Keighley
M R
MR
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