title: Long-term results after anterior sphincteroplasty for anal incontinence.
abstract: OBJECTIVE
  To assess the long term incontinence and quality of life (Qol) results after elective anterior sphincteroplasty for anal incontinence.
  
  
  METHODS
  Short and long term follow-up included respectively 28 and 25 of the 29 patients who were operated between 1989 and 1998 in our institution. Qol was assessed with gastro intestinal quality of life index (GIQLI). Incontinence was graded according to Parks score supplied with St Mark's score at long term follow-up.
  
  
  RESULTS
  21 (73%) patients had a history of obstetric sphincter tears. Mean age at operation was 45 years (range 6-77). Median time from operation to short term follow-up was 26 months (mean 38 months, range 2-113) and 84 months (mean 105, range 74-185) to long term follow-up. At short term follow-up 19 of 28 patients (68%) were continent for stool compared with nine of 25 patients (36%) at long term follow-up. Nine of 17 (53%) who were continent for stool at short term follow-up remained continent for stool at long term follow-up. Patients with a history of obstetric sphincter tear had less severe incontinence at long term follow-up compared to women with other causes of incontinence (St. Mark's score 8 and 16 respectively, p = 0,015). Patients with no incontinence or gas incontinence only, had higher quality of life score at both follow-ups than those who where incontinent for stool (p = 0,007 and p= 0,014 respectively).
  
  
  CONCLUSIONS
  More than half of the patients remained continent for stool at long term follow-up. Continence for stool was associated with high Qol score.
authors.affiliation: Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway. kjersti.mevik@unn.no
authors.forename: K
authors.initials: K
authors.lastname: Mevik
authors.forename: S
authors.initials: S
authors.lastname: Norderval
authors.forename: H
authors.initials: H
authors.lastname: Kileng
authors.forename: M
authors.initials: M
authors.lastname: Johansen
authors.forename: B
authors.initials: B
authors.lastname: Vonen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult