Anoplasty for Anal Stenosis

Abstract

Although most cases of anal stenosis appear to follow a previous hemorrhoidectomy, we have encountered a number of elderly patients, especially women, who developed this condition without having had any prior surgery. The etiology in these cases is not clear. However, in most cases of anal stenosis the stricture appears to be limited to the superficial layer of the anal canal without much involvement of the sphincter musculature. Because of this fact, it is not difficult to dissect the anoderm and rectal mucosa away from the muscle, making enlargement of the anal orifice possible by the simple application of the Heineke-Mikulicz principle. We have been pleased with this technique except for severe cases. When marked fibrosis occurs, construct a sliding skin flap to fill in the defect.