[Results of anterior levator and externus-plasty in idiopathic anorectal incontinence. A prospective manometric, electromyography and radiology study].

A prospective clinical manometric and radiological study has been performed, before and after anterior levatorplasty and sphincter plication on 18 patients (mean age 61.6 years) with neurogenic faecal incontinence. Continence was improved on 15 (83%) patients, 13 (72%) patients were continent to solid and liquid stool, 3 (17%) of whom regained normal continence only, at a minimum of 6 months follow-up (phi 21.5 months). Postoperatively there was a significant increase in the resting anal pressure (p = 0.05) an maximum voluntary contraction pressure (p = 0.001). No significant change in sphincter length, duration of the action potentials, pudendal nerve terminal motor latency (PNTML), pelvic descent or anorectal angle was seen postoperatively. The incontinence and defaecation-score showed postoperatively a significant difference concerning soiling, time from urgency to defaecation, and discrimination between flatus and stool.