Abstract
Seventy-six operative procedures for anal incontinence performed at the Lahey Clinic Medical Center between 1964 and 1985 were reviewed. Etiologic factors, findings on preoperative physical examination, and functional results are reported for 61 procedures in the four categories of simple anterior reefing, anterior reefing with perineal body reconstruction and anoplasty skin closure, posterior proctopexy, and Dacron Silastic® sling insertion. In women with anterior sphincter defects, combining anoplasty skin closure and deep external sphincter plication gives superior functional results over superficial reefing, especially when there is attenuation of the rectovaginal septum and perineal body. The posterior proctopexy is most useful in patients with intact external sphincters and incontinence without recognizable cause or after abdominal repair of rectal prolapse.
Similar content being viewed by others
References
Henry MM, Swash M, eds. Coloproctology and the pelvic floor: pathophysiology and management. London: Butterworths, 1985:217.
Keighley MRB, Fielding JW. Management of faecal incontinence and results of surgical treatment. Br J Surg 1983;70:463–8.
Henry MM, Simson JN. Results of postanal repair: a retrospective study. Br J Surg 1985:72(September suppl):S17–8.
Corman ML. Anal incontinence following obstetrical injury. Dis Colon Rectum 1985;28:86–9.
Horn HR, Schoetz DJ Jr, Coller JA, Veidenheimer MC. Sphincter repair with a Silastic® sling for anal incontinence and rectal procidentia. Dis Colon Rectum 1985;28:868–72.
Fang DT, Nivatvongs S, Vermeulen FD, Herman FN, Goldberg SM, Rothenberger DA. Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum 1984;27:720–2.
Corman ML. Management of fecal incontinence by gracilis muscle transposition. Dis Colon Rectum 1979;22:290–2.
Corman M. Follow-up evaluation of gracilis muscle transposition for fecal incontinence. Dis Colon Rectum 1980;23:552–5.
Corman M. Gracilis muscle transposition for anal incontinence: late results. Br J Surg 1985;72 (September suppl):S21–2.
Warren JC. A new method of operation for the relief of rupture of the perineum through the sphincter and rectum. Trans Am Gynecol Soc 1882;7:322–30.
Nesselrod JP. Proctology in general practice. Philadelphia: WB Saunders, 1950.
Russell TR, Gallagher DM. Low rectovaginal fistulas. Am J Surg 1977;134:13–7.
Parks AG. Anorectal incontinence. Proc R Soc Med 1975;68:681–90.
Bartolo DC, Jarratt JA, Read MG, Donnelly TC, Read NW. The role of partial denervation of the puborectalis in idiopathic faecal incontinence. Br J Surg 1983;70:664–7.
Snooks SJ, Swash M, Henry MM, Setchell M. Risk factors in childbirth causing damage to the pelvic floor innervation. Br J Surg 1985;72 (September suppl):S15–7.
Browning GG, Parks AG. Postanal repair for neuropathic faecal incontinence: correlation of clinical result, and anal canal pressures. Br J Surg 1983;70:101–4.
Mahieu P, Pringot J, Bodart P. Defecography: II. Contribution to the diagnosis of defecation disorders. Gastrointest Radiol 1984;9: 253–61.
Swash M. Anorectal incontinence: electrophysiological tests. Br J Surg 1985;72 (September suppl):S14–5.
Labow S, Rubin RJ, Hoexter B, Salvati EP. Perineal repair of rectal procidentia with an elastic fabric sling. Dis Colon Rectum 1980;23:467–9.
Larach SW, Vazquez B. Modified Thiersch procedure with Silastic mesh implant: a simple solution for fecal incontinence and severe prolapse. South Med J 1986;79:307–9.
Shackelford RT, Zuidema GD. Surgery of the alimentary tract. 2nd ed. Philadelphia: WB Saunders, 1982;3:632.
Schoetz DJ Jr. Operative therapy for anal incontinence. Surg Clin North Am 1985;65:35–46.
Motson RW. Sphincter injuries: indications for, and results of sphincter repair. Br J Surg 1985;72 (September suppl):S19–21.
Browning GG, Motson RW. Anal sphincter injury: management and results of Parks sphincter repair. Ann Surg 1984;199:351–7.
Author information
Authors and Affiliations
Additional information
Poster presentation at the meeting of the American Society of Colon and Rectal Surgeons, Washington, D.C., April 5 to 10, 1987.
About this article
Cite this article
Stricker, J.W., Schoetz, D.J., Coller, J.A. et al. Surgical correction of anal incontinence. Dis Colon Rectum 31, 533–540 (1988). https://doi.org/10.1007/BF02553727
Issue Date:
DOI: https://doi.org/10.1007/BF02553727