Can the external anal sphincter be preserved in the treatment of trans-sphincteric fistula-in-ano?

A method of preserving the external anal sphincter in the treatment of complex trans-sphincteric fistula-in-ano is described. Cure without division of the external sphincter was possible in 44% of cases. Disturbances of continence, common after conventional fistula surgery, appeared to be reduced in those patients whose external sphincter remains intact.