Preliminary experience in management of fecal incontinence caused by internal anal sphincter injury.
OBJECTIVE
Isolated injuries of the internal anal sphincter can cause fecal incontinence. With the advent of ultrasound, which accurately delineates the anatomy of the anal sphincters, internal sphincter injuries can be diagnosed more precisely. The purpose of this study was to evaluate the outcome of direct repair of isolated internal anal sphincter defects.


METHODS
Eight patients (6 males; median age, 37 years) with clinically and sonographically proved internal anal sphincter defects were the subject of this study. Patients had different degrees of incontinence that failed to respond to medical treatment. All patients had their sphincters repaired by direct apposition using coated Vicryl 2-0 stitches. A strict postoperative regime that avoided stretch of the sphincter for one month was adopted.


RESULTS
At a median follow-up period of 15 months, continence improved in all patients, and two achieved full continence. None of the patients wore pads. Mean continence score improved significantly from 4 to 12 and 11 at 6 and 12 postoperative months, respectively (P < 0.0001, paired t-test).


CONCLUSIONS
Despite the limited number of patients and the short follow-up, the preliminary results of repair of isolated internal sphincter defects are satisfactory.
Abou-Zeid
A A
AA
Department of Surgery, El Demerdash Hospital, Ain Shams University, Cairo, Egypt.
D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000293:injuries*; D020099:Coated Materials, Biocompatible; D013505:Digestive System Surgical Procedures / Q000379:methods*; D019160:Endosonography; D005242:Fecal Incontinence / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery
D020099:Coated Materials, Biocompatible