[Fecal incontinence following anal sphincter rupture: influence of the aetiology on the repair results].
Short-term functional results are usually good after sphincter repair but they could deteriorate with time if the disruption is due to obstetric damage. The aim of this study was to compare short and long-term results after sphincter repair according to the etiology of the damage.


METHODS
Fifty-five women have been operated on for a sphincter disruption due to obstetrical damage (Ob) (28) or to postoperative damage (Op) (27) and were retrospectively studied. Surgical procedure was similar for every patients but the puborectalis muscle was also approximated in case of obstetric damage. Functional results were recorded by clinical examinations two months after the operation and during the year 2001.


RESULTS
The two groups were similar, except for the rate of defunctionning stoma undergone and for the duration of symptoms before the operation. Mortality and morbidity were similar between the two groups. Short-term functional results were better in the postoperative group (96 vs 78%) (P =0.05). At the end of the follow-up the results remained significantly better in group Op (85 vs 65%; P <0.05). The cumulative rates of functional good results also decreased more rapidly in group Ob but the difference was not significant.


CONCLUSIONS
Short and long-time functional results after sphincter repair seem to be better in case of postoperative disruption. Pudendal nerve damages frequently observed after traumatic delivery could explain this difference.
Martel
P
P
Service de chirurgie générale et digestive B, hôpital Bichat, 46, rue Henri-Huchard, 75877 Paris cedex 18, France. philippe.martel@bch.ap-hop-paris.fr
Malafosse
M
M
Lecomte
P
P
Gallot
D
D
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000293:injuries* / Q000601:surgery*; D001004:Anus Diseases / Q000150:complications* / Q000601:surgery*; D005242:Fecal Incontinence / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012421:Rupture; D012422:Rupture, Spontaneous; D013997:Time Factors