title: Overlapping sphincter repair:  does age matter?
abstract: BACKGROUND
  The predictors of the outcomes following anal sphincteroplasty have not been well documented.
  
  
  OBJECTIVE
  The aim was to evaluate age as a predictor of functional outcome and quality of life after overlapping sphincter repair.
  
  
  METHODS
  This study is a retrospective review of chart review followed by a prospective evaluation by the use of validated questionnaires.
  
  
  METHODS
  Patients were assigned to group A (≤ 60 years old) or group B (>60 years).
  
  
  METHODS
  Included were patients with obstetric sphincter injuries who underwent overlapping sphincteroplasty between 1996 and 2007.
  
  
  METHODS
  The Fecal Incontinence Quality of Life Scale, Fecal Incontinence Severity Index, the Cleveland Global Quality of Life scale, and a patient satisfaction questionnaire were used to assess outcome.
  
  
  RESULTS
  Three hundred twenty-one women underwent sphincteroplasty and 197 responded to this study, 146 (74.1%) patients in group A and 51 (25.9%) patients in group B. Median follow-up was 7.7 years (range, 4.7-10.0). The mean overall Fecal Incontinence Quality of Life Scale was 11.0 ± 3.5. Median Fecal Incontinence Severity Index score was 29.8 ± 15.9. Mean Cleveland Global Quality of Life scale was 0.7 ± 0.2. The 2 groups were comparable for BMI (p = 1.0), ethnic background (p = 0.8), smoking (p = 0.8), and follow-up duration (p = 0.9). Intergroup comparison showed no significant difference in the Fecal Incontinence Quality of Life Scale scores (p = 0.5) in all subscales: lifestyle (p = 0.8), coping behavior (p = 0.5), depression and self-perception (p = 0.2), and embarrassment (p = 0.1). No significant differences were noted in Fecal Incontinence Severity Index (p = 0.2), Cleveland Global Quality of Life scale (p =1.0), or postoperative satisfaction (p = 0.6).
  
  
  CONCLUSIONS
  The study was limited by its retrospective nature.
  
  
  CONCLUSIONS
  Comparable long-term Fecal Incontinence Severity Index score and Fecal Incontinence Quality of Life Scale scores following overlapping sphincter repair suggest that age is not a predictor of outcome for overlapping sphincter repair. This procedure can be offered to both young and older patients.
authors.affiliation: Pelvic Floor Unit, Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: G
authors.initials: G
authors.lastname: El-Gazzaz
authors.forename: M
authors.initials: M
authors.lastname: Zutshi
authors.forename: C
authors.initials: C
authors.lastname: Hannaway
authors.forename: B
authors.initials: B
authors.lastname: Gurland
authors.forename: T
authors.initials: T
authors.lastname: Hull
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001003:Anal Canal / Q000293:injuries / Q000601:surgery*; D001720:Birth Injuries; D036861:Delivery, Obstetric / Q000009:adverse effects; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life