Overlapping anal sphincter repair and anterior levatorplasty: effect of patient's age and duration of follow-up.

BACKGROUND AND AIMS: Anal sphincter repair can improve function in patients with faecal incontinence but it is unclear which benefit and its long-term efficacy has been questioned. This study aims to assess the functional outcome of a single surgeon series of overlapping anal sphincter repairs with anterior levatorplasty.

METHOD: A retrospective study of 66 patients' case notes and anorectal physiology combined with an interview to assess their current continence and associated quality of life after surgery.

RESULTS

Sixty-six female patients, mean age 62.8 years, mean follow-up 45.2 months, were assessed. Functional improvement in continence was seen in 77.1% of patients, which mirrored their subjective rating of surgery (62.7%--good/excellent). Continence grading scores improved from a mean (SD) 9.71 (4.82) pre-surgery to 5.55 (4.11) post-surgery. There was no statistical difference in functional results when stratified by age (<63 years or > or =63 years) or by follow-up [long-term (43-78 months) vs short-term (14-42 months)]. Post-surgical physiology data were not statistically improved compared to pre-surgery.

CONCLUSIONS

Overlapping anal sphincter repair with anterior levatorplasty is an effective treatment for faecal incontinence. Patient age does not correlate with outcome, and symptoms do not deteriorate over time. Anorectal physiology results don't predict for symptomatic improvement in patients with faecal incontinence.