Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five year follow-up functional results.
Disruption of the anal sphincter results from obstetric injury, ano-rectal operations or external trauma. Obstetric or surgical division of the sphincteric mechanism may not be immediately apparent and the clinical presentation of incontinence may occur several years later [1, 2]. Reconstruction of the sphincter using a fascial sling or direct end-to-end repair of the disrupted sphincter result in a high failure rate. Failure after direct end-to-end repair is usually caused by break down of the suture line owing to retraction of the muscle ends [3]. Parks advocated an overlapping repair [4] in which the disrupted ends of the sphincter were mobilised and wrapped around each other. This paper reports the results of overlapping sphincter repair for faecal incontinence resulting from trauma, after a 5 year follow-up period.
Londono-Schimmer
E E
EE
St. Mark's Hospital, London, UK.
Garcia-Duperly
R
R
Nicholls
R J
RJ
Ritchie
J K
JK
Hawley
P R
PR
Thomson
J P
JP
D000328:Adult; D001003:Anal Canal / Q000293:injuries* / Q000601:surgery*; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D011247:Pregnancy; D013997:Time Factors