title: Overlapping anal sphincteroplasty: impact of suture selection on bowel symptoms.
abstract: OBJECTIVE
  To look at women who underwent overlapping anal sphincteroplasty (OAS) with the use of either permanent or absorbable sutures and to describe patient-reported fecal continence and quality of life.
  
  
  METHODS
  A case series of 40 women who underwent OAS completed the Modified Manchester Health Questionnaire a mean of 50 months after surgery. Descriptive statistics were used to describe those who had permanent sutures and those who had absorbable sutures.
  
  
  RESULTS
  The primary outcome, loss of solid stool, was similar at 50% for each group. Severity of incontinence symptoms, as measured by the Fecal Incontinence Severity Index, was lower in the permanent suture group (15.9 vs. 24.0). There was no difference in overall impact on quality of life.
  
  
  CONCLUSIONS
  While overall patient-reported fecal incontinence was similar, permanent suture use at time of OAS was associated with decreased fecal incontinence severity.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA. bparnell@med.unc.edu
authors.forename: Brent A
authors.initials: BA
authors.lastname: Parnell
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Geller
authors.forename: Mary L
authors.initials: ML
authors.lastname: Jannelli
authors.forename: AnnaMarie
authors.initials: A
authors.lastname: Connolly
mesh_terms: D020341:Absorbable Implants; D001003:Anal Canal / Q000601:surgery*; D004867:Equipment Design; D005242:Fecal Incontinence / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013537:Sutures