title: How I do it. Anal stenosis.
abstract: BACKGROUND
  Anal stenosis represents a technical challenge in terms of surgical management. It is a rare but serious complication of anorectal surgery, most commonly seen after surgical hemorrhoidectomy. However, stenosis can also occur in the absence of an anorectal surgical history.
  
  
  METHODS
  A review of the current surgical literature was performed. The etiology, classification, and diagnostic modalities for anal stenosis were reviewed. A detailed overview of surgical and nonsurgical therapeutic options was developed.
  
  
  CONCLUSIONS
  Anal stenosis may be anatomic (stricture) or functional (muscular). Anal stricture is most often a preventable complication. It is most commonly seen after overzealous surgical hemorrhoidectomy. A well-performed hemorrhoidectomy is the best way to avoid anal stricture. Symptomatic mild functional stenosis and stricture may be managed conservatively with diet, fiber supplements, and stool softeners. A program of gradual manual or mechanical dilatation may be required. Sphincterotomy and various techniques of anoplasty have been used successfully in the treatment of symptomatic moderate to severe functional anal stenosis and stricture, respectively.
authors.affiliation: Department of Surgery, Section of Colon and Rectal Surgery, Creighton University School of Medicine, Omaha, Nebraska, USA.
authors.forename: H
authors.initials: H
authors.lastname: Liberman
authors.forename: A G
authors.initials: AG
authors.lastname: Thorson
mesh_terms: D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D013524:Surgical Flaps