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Anterior sphincter repair 

Anterior sphincter repair
Chapter:
Anterior sphincter repair
Author(s):

Sophie Pilkington

DOI:
10.1093/med/9780199579624.003.0023
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date: 26 January 2021

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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