Late results of anterior sphincter plication for traumatic faecal incontinence.

OBJECTIVE

To assess the long term clinical results of anterior sphincter plication for traumatic rupture of the anal sphincters.

DESIGN

Retrospective study.

SETTING

University hospital, The Netherlands.

SUBJECTS: 28 consecutive patients with traumatic faecal incontinence after injury to the anal sphincters.

MAIN OUTCOME MEASURES: Clinical outcome and its correlation with anorectal manometry.

RESULTS

After a mean (SD) follow up of 50 (37) months 21 patients were classified grades 1 and 2 (satisfied) and seven patients were grades 3 and 4 (classified). There were significant differences after operation between the 21 patients in grades 1 and 2 compared with the 7 in grades 3 and 4 in median resting pressure (43 compared with 25 mmHg, p = 0.004, 95% CI 9 to 40), and squeeze pressure (100 compared with 40 mmHg, p = 0.001, 95% CI 15 to 80) but not in length of high pressure zone (3.5 compared with 2.3 cm, p = 0.14, 95% CI -0.2 to +2.2). (Mann Whitney U test was used.)

CONCLUSION

Long term follow up of patients after anterior sphincter plication showed good results in three quarters of patients, and 57% were fully continent. Good postoperative results correlate with significant increases in resting and squeeze pressures.