INTERNAL ANAL-SPHINCTER REPAIR

The results of repair to the internal and sphincter alone has been eva luated in five patients with persistent anal incontinence following su rgery which affected the internal anal sphincter. All had passive inco ntinence for solid or liquid stool. Symptoms, anorectal manometry, and anal endosonography were evaluated before and after surgery. After su rgery three patients felt improved but had still persistent symptoms, and no patients achieved full continence. Three patients showed an inc reased maximal and resting pressure, but only one of them was within t he normal range. Post operatively, all the anal ultrasound scans showe d a persistent internal sphincter defect, and two showed an unsuspecte d external anal sphincter defect. Although some patients felt symptoma tically improved, the overall clinical, manometric and radiological fi ndings after internal and sphincter repair were disappointing.