[Results of overlapping sphincter repair in response to obstetric injury].
BACKGROUND
Obstetric trauma is one of the most common causes of faecal incontinence, and the standard therapy for clear sphincter defects is overlapping sphincter repair. We aimed to assess the short-term success rates of sphincter repair using modified V-Y plastic without covering colostomy and with primary closure of the perineum.


METHODS
Between November 1997 and March 2002, 21 patients were operated on for faecal incontinence due to obstetric trauma. Cleveland Clinic Incontinence Score (CCIS), patients' subjective assessment, and pathophysiological parameters were evaluated pre- and postoperatively.


RESULTS
At follow-up, 19 patients (90%) reported improvements in continence symptoms over their preoperative situations. Three patients (14%) classified themselves subjectively as fully continent, six (28%) as highly improved, ten (48%) as improved, and two (10%) as unchanged.


CONCLUSIONS
Our results indicate that faecal diversion is not necessary in sphincter repair and that primary perineal wound closure should be performed. Patients' subjective assessments and CCIS are suitable tools for evaluating improvements in faecal incontinence.
Kopf
C
C
Chirurgische Abteilung, Krankenhaus Barmherzige Brüder, Linz, Osterreich. christoph.kopf@bblinz.at
Haidinger
W
W
Haidinger
D
D
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000293:injuries* / Q000601:surgery*; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000601:surgery*; D017060:Patient Satisfaction; D011247:Pregnancy; D013536:Suture Techniques