- Foreword
- Preface
- Contributors list
- Chapter 1 Establishing and developing a pelvic floor service: the multidisciplinary team and the approach to patient assessment
- Chapter 2 Radiological workup
- Chapter 3 Anorectal physiology
- Chapter 4 Faecal incontinence: a pathophysiological approach
- Chapter 5 Obstructed defaecation: a pathophysiological approach
- Chapter 6 Chronic anorectal pain: a pathophysiological approach
- Chapter 7 Conservative treatment of pelvic floor disorders
- Chapter 8 Three compartments–working with a multidisciplinary team
- Chapter 9 Internal rectal prolapse
- Chapter 10 Anismus
- Chapter 11 Rectocele
- Chapter 12 Solitary rectal ulcer syndrome (SRUS)
- Chapter 13 Slow transit constipation
- Chapter 14 Perineoproctology (fissures and haemorrhoids)
- Chapter 15 Pudendal pain syndrome
- Chapter 16 Obstetric sphincter injury
- Chapter 17 Rectal sensory dysfunction
- Chapter 18 Laparoscopic ventral rectopexy (with posterior colporraphy and vaginal sacrocolpopexy)
- Chapter 19 STARR and Transtar
- Chapter 20 Complete pelvic floor ultrasound
- Chapter 21 Sacral neuromodulation
- Chapter 22 Anal bulking
- Chapter 23 Anterior sphincter repair
- Chapter 24 Neosphincters and artificial sphincters for treating faecal incontinence
- Index
(p. 251) Anterior sphincter repair
- Chapter:
- (p. 251) Anterior sphincter repair
- Author(s):
Sophie Pilkington
- DOI:
- 10.1093/med/9780199579624.003.0023
Chapter 23 discusses anterior sphincter repair, an excellent procedure for selected patients with faecal incontinence, particularly the younger patient presenting relatively soon after obstetric trauma, as well as that the older patient with a delayed presentation is probably better suited to sacral neuromodulation (SNS). Patients with incontinence and a cloacal deformity represent the prime indication for sphincter repair over other techniques. Technically speaking, the internal anal sphincter should be identified separately and imbricated if possible, and ideally a nerve-stimulator is very useful to distinguish skeletal muscle. Any method to reduce the high incidence of wound breakdown (oblique or introital incisions) is commended. Sphincter repair should not be undertaken without a thorough interrogation of the pelvic floor.
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- Foreword
- Preface
- Contributors list
- Chapter 1 Establishing and developing a pelvic floor service: the multidisciplinary team and the approach to patient assessment
- Chapter 2 Radiological workup
- Chapter 3 Anorectal physiology
- Chapter 4 Faecal incontinence: a pathophysiological approach
- Chapter 5 Obstructed defaecation: a pathophysiological approach
- Chapter 6 Chronic anorectal pain: a pathophysiological approach
- Chapter 7 Conservative treatment of pelvic floor disorders
- Chapter 8 Three compartments–working with a multidisciplinary team
- Chapter 9 Internal rectal prolapse
- Chapter 10 Anismus
- Chapter 11 Rectocele
- Chapter 12 Solitary rectal ulcer syndrome (SRUS)
- Chapter 13 Slow transit constipation
- Chapter 14 Perineoproctology (fissures and haemorrhoids)
- Chapter 15 Pudendal pain syndrome
- Chapter 16 Obstetric sphincter injury
- Chapter 17 Rectal sensory dysfunction
- Chapter 18 Laparoscopic ventral rectopexy (with posterior colporraphy and vaginal sacrocolpopexy)
- Chapter 19 STARR and Transtar
- Chapter 20 Complete pelvic floor ultrasound
- Chapter 21 Sacral neuromodulation
- Chapter 22 Anal bulking
- Chapter 23 Anterior sphincter repair
- Chapter 24 Neosphincters and artificial sphincters for treating faecal incontinence
- Index