Results of sphincteroplasty in 86 patients with anal incontinence.
OBJECTIVE
This study was designed to analyze critically the short-term and long-term outcome of sphincteroplasty and to identify high-risk factors.


METHODS
Eighty-six patients with fecal incontinence associated with an ultrasound defect of the external anal sphincter were treated by anal sphincteroplasty. Clinical and physiologic assessment was made before surgery, and clinical evaluation was made three months and an average of 40 months after surgery.


RESULTS
The evaluation of 86 patients three months after surgery showed that 42 patients were totally continent (49 percent), 28 were incontinent for gas (33 percent), and 16 still had fecal incontinence (19 percent). Seventy-four patients (86 percent) were contacted 40 months after surgery. Twenty-one patients (28 percent) were totally continent, 17 were incontinent to gas (23 percent), and 36 were incontinent to feces (49 percent). Forty-six percent of patients felt they were clearly improved after surgery. Poor results were associated with an internal anal sphincter defect.


CONCLUSIONS
Our study suggests that in the long term, one-third of patients are totally continent after sphincteroplasty. One-half of patients are satisfied, but only if their incontinence to feces has totally disappeared. Results of sphincteroplasty deteriorate with time. One factor in poor prognosis is the presence of an associated defect of the internal anal sphincter.
Karoui
S
S
Groupe de Recherche sur l'Appareil Digestif, Centre Hospitalier Régional et Universitaire de Rouen, France.
Leroi
A M
AM
Koning
E
E
Menard
J F
JF
Michot
F
F
Denis
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D005242:Fecal Incontinence / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome