title: Complete anal sphincter complex disruption from intercourse: A case report and literature review.
abstract: BACKGROUND
  Anal sphincter injuries are uncommon injuries outside of obstetric practice - but they may cause disastrous complications.
  
  
  METHODS
  We present a case of complete anal sphincter disruption from anal intercourse in a 25 year old woman. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after 154 days of follow up.
  
  
  CONCLUSIONS
  This is one of a handful of reported cases of anal sphincter disruption secondary to anal intercourse. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. There is little evidence to support simultaneous faecal diversion for primary repair of acute perineal lacerations.
  
  
  CONCLUSIONS
  Acute post-coital sphincter injuries should be treated operatively on an emergent basis, without diversion because they are low energy injuries with minimal tissue loss and excellent blood supply. Although repair of each injury should be individualized, the majority of these injuries do not require concomitant protective colostomy creation.
authors.affiliation: Department of Surgery, University of the West Indies, Mona Campus, Kingston 7, Jamaica.
authors.forename: S O
authors.initials: SO
authors.lastname: Cawich
authors.forename: L
authors.initials: L
authors.lastname: Samuels
authors.forename: I
authors.initials: I
authors.lastname: Bambury
authors.forename: C J
authors.initials: CJ
authors.lastname: Cherian
authors.forename: L
authors.initials: L
authors.lastname: Christie
authors.forename: S
authors.initials: S
authors.lastname: Kulkarni