What is Sphincteroplasty?

Sphincteroplasty (also called anterior sphincter repair or overlapping sphincteroplasty) is a surgical procedure that repairs a torn or disrupted external anal sphincter muscle. It is most commonly performed for faecal incontinence caused by obstetric injury (third or fourth degree perineal tear during childbirth) or previous anorectal surgery.

Who Benefits from Sphincteroplasty?

• Women with identified sphincter defect on endoanal ultrasound following childbirth injury
• Patients with anterior sphincter disruption after anorectal surgery (haemorrhoidectomy, fistula surgery)
• Best results when pudendal nerve function is intact (tested by nerve latency)
• Age below 60 — younger patients have better long-term outcomes

The Procedure

Under general or spinal anaesthesia, a curved perineal incision exposes the torn sphincter muscle ends. The scarred ends are overlapped and sutured together (overlapping repair) — or, in some cases, sutured end-to-end. A temporary diverting stoma is occasionally used for complex repairs. Hospital stay: 2–3 days.

Results

• Short-term (1–2 years): good continence in 70–80% of patients
• Long-term (5+ years): results deteriorate — 50–60% maintain improvement
• For patients with failed sphincteroplasty: Sacral Nerve Stimulation (SNS) is highly effective