Anal stenosis

BACKGROUND: Anal stenosis represents a technical challenge in terms of surg ical management. It is a rare but serious complication of anorectal surgery , most commonly seen after surgical hemorrhoidectomy. However, stenosis can also occur in the absence of an anorectal surgical history. DATA SOURCES: A review of the current surgical literature was performed. Th e etiology, classification, and diagnostic modalities for anal stenosis wer e reviewed. A detailed overview of surgical and nonsurgical therapeutic opt ions was developed. CONCLUSIONS: Anal stenosis may be anatomic (stricture) or functional (muscu lar), Anal stricture is most often a preventable complication. It is most c ommonly seen after overzealous surgical hemorrhoidectomy. A well-performed hemorrhoidectomy is the best way to avoid anal stricture. Symptomatic mild functional stenosis and stricture may be managed conservatively with diet, fiber supplements, and stool softeners. A program of gradual manual or mech anical dilatation may be required. Sphincterotomy and various techniques of anoplasty have been used successfully in the treatment of symptomatic mode rate to severe functional anal stenosis and stricture, respectively. Am J S urg. 2000;179:325-329. (C) 2000 by Excerpta Medica, Inc.