CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(03): 332-334
DOI: 10.1055/s-0041-1735543
Technical Note

End-to-end anal Sphincter Repair in Treatment of Post-traumatic Fecal Incontinence

1   General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
,
1   General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
› Author Affiliations

Abstract

The present report describes the end-to-end technique of anal sphincter repair in a 36-year-old female patient with post-vaginal delivery fecal incontinence (FI). The patient had a history of two vaginal deliveries and the symptoms of FI were observed after the second delivery. On assessment of the severity of FI using the Wexner incontinence score, the patient had a score of 12. Endoanal ultrasonography revealed an anterior defect of the external anal sphincter extending from 11 to 3 o'clock. The patient had no previous anal surgery and did not have any medical comorbidities.

The operation time was 45 minutes. No intraoperative complications were recorded. At 12 months of follow-up, the patient showed significant improvement in the continence state, with her Wexner score dropping to 4. No postoperative complications were recorded. We can conclude that end-to-end anal sphincter repair is a technically feasible operation that confers satisfactory improvement in the continence state without imposing much tension on the site of sphincter repair.

Author contributions

Emile S. edited the video and wrote the manuscript. El-Said M. performed the procedure and revised the manuscript.




Publication History

Received: 16 December 2020

Accepted: 15 June 2021

Article published online:
20 September 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Bartlett L, Nowak M, Ho YH. Impact of fecal incontinence on quality of life. World J Gastroenterol 2009; 15 (26) 3276-3282 DOI: 10.3748/wjg.15.3276.
  • 2 Caputo RM, Benson JT. Idiopathic fecal incontinence. Curr Opin Obstet Gynecol 1992; 4 (04) 565-570
  • 3 Eason E, Labrecque M, Marcoux S, Mondor M. Anal incontinence after childbirth. CMAJ 2002; 166 (03) 326-330
  • 4 Farrell SA. Overlapping compared with end-to-end repair of third and fourth degree obstetric anal sphincter tears. Curr Opin Obstet Gynecol 2011; 23 (05) 386-390 DOI: 10.1097/GCO.0b013e32834a91e8.
  • 5 Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993; 36 (01) 77-97 DOI: 10.1007/BF02050307.
  • 6 Fitzpatrick M, Behan M, O'Connell PR, O'Herlihy C. A randomized clinical trial comparing primary overlap with approximation repair of third-degree obstetric tears. Am J Obstet Gynecol 2000; 183 (05) 1220-1224
  • 7 Williams A, Adams EJ, Tincello DG, Alfirevic Z, Walkinshaw SA, Richmond DH. How to repair an anal sphincter injury after vaginal delivery: results of a randomised controlled trial. BJOG 2006; 113 (02) 201-207 DOI: 10.1111/j.1471-0528.2006.00806.x.
  • 8 Fernando RJ, Sultan AH, Kettle C, Radley S, Jones P, O'Brien PM. Repair techniques for obstetric anal sphincter injuries: a randomized controlled trial. Obstet Gynecol 2006; 107 (06) 1261-1268
  • 9 Farrell SA, Flowerdew G, Gilmour D. et al. Overlapping compared with end-to-end repair of complete third-degree or fourth-degree obstetric tears: three-year follow-up of a randomized controlled trial. Obstet Gynecol 2012; 120 (04) 803-808 DOI: 10.1097/AOG.0b013e31826ac4bb.