Long-term outcome of overlapping anal sphincter repair.
OBJECTIVE
This study reviews the long-term outcome of overlapping anal sphincteroplasty for acquired anal incontinence.


METHODS
Seventy-one consecutive patients underwent overlapping sphincteroplasty from 1989 to 1996 Current degree of continence and associated quality of life were determined by telephone interview using the Fecal Incontinence Severity Index and Fecal Incontinence Quality of Life Scale, as validated by The American Society of Colon and Rectal Surgeons. Both the patient-rated and the surgeon-rated Fecal Incontinence Severity Index scores were recorded. Demographic and perioperative data were obtained from patient charts.


RESULTS
Forty-nine (69 per cent) of the 71 patients, with a median age of 38.5 (range, 22-80) years, could be contacted at a median of 69 (range, 48-141) months after sphincter repair. Four patients were diverted at the time of follow-up. Twenty-four (54 percent) patients were incontinent to liquid or solid stool, and only six patients (14 percent) were totally continent. Fifteen patients (34 percent) had the best possible Fecal Incontinence Quality of Life score of 16. The median patient-rated and surgeon-rated Fecal Incontinence Severity Index scores were 20 (range, 0-61) and 20 (range, 0-57), respectively. The patient-rated score correlated to the surgeon-rated score (r = 0.98, P < 0.001) and the Fecal Incontinence Quality of Life score (r = 0.64, P < 0.001).


CONCLUSIONS
Years after sphincter repair surgery more than half of the patients are incontinent to liquid or solid stool. The American Society of Colon and Rectal Surgeons-validated Fecal Incontinence Severity Index and Fecal Incontinence Quality of Life scores are useful and complementary tools for evaluation of fecal incontinence.
Halverson
Amy L
AL
Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, Ohio, USA.
Hull
Tracy L
TL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index; D013105:Sphincterotomy, Transduodenal; D013997:Time Factors