Sphincteroplasty | Anal Sphincter Repair Surgery

Sphincteroplasty

Anal Sphincter Repair by Dr. Ashok Kumar

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What is Sphincteroplasty?

Surgical repair of external anal sphincter for fecal incontinence. Overlapping repair technique restores sphincter continuity and function. Indicated for obstetric or traumatic sphincter injury.

Indications

  • Sphincter defects from childbirth
  • Traumatic injury
  • Obstetric anal sphincter injury (OASI)
  • Post-surgical defects

Pre-operative Assessment

Anorectal manometry, endosonography to evaluate sphincter defects. Patient counseling on expectations and continence improvement.

Surgical Technique

Identification of sphincter ends. Overlapping repair with absorbable sutures. Restores muscular continuity. Can involve graciloplasty or other techniques in complex cases.

Recovery

Hospital stay 1-2 days. Return to activities 4-6 weeks. Healing 8-12 weeks. Continence improvement takes several months. Success rate 60-70%.

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What is sphincteroplasty?

Sphincteroplasty is an operation to repair a damaged anal sphincter, the ring of muscle that controls bowel movements. It is most often done for women whose sphincter was torn during childbirth, but it may also help after injury or previous anal surgery.

Who is it for?

  • People with faecal incontinence caused by a defect in the sphincter muscle that is seen on endoanal ultrasound
  • Symptoms that have not improved enough with diet, medicines, pelvic floor exercises and biofeedback
  • Patients with a recent or old childbirth injury

How the repair is done

Under spinal or general anaesthesia, a curved cut is made in the skin between the anus and the vagina or scrotum. The torn ends of the sphincter muscle are found, freed from scar tissue and overlapped, then stitched together to rebuild the ring. The skin is closed, sometimes leaving a small part open to drain.

Recovery

  • Hospital stay is usually two to four days
  • You will be given stool softeners to avoid straining on the repair
  • Wound care includes keeping the area clean and dry and warm sitz baths
  • Avoid heavy lifting and strenuous activity for about six weeks
  • Pelvic floor exercises or biofeedback may be advised afterwards to get the best result

What results to expect

Many patients notice better control, especially of solid stool. The benefit can lessen over several years, and some people may need additional treatment later. Your surgeon will discuss realistic expectations based on your tests.

Possible risks

Risks include wound infection, delayed wound healing, bleeding, pain and the possibility that symptoms are not fully corrected.

Frequently asked questions

Can sphincteroplasty be done years after childbirth?

Yes. Repair can be considered even many years after the injury if tests show a defect in the muscle.

What if the repair does not help enough?

Other options include biofeedback and sacral nerve stimulation, which works on the nerves that control the bowel.

Can I have more children after repair?

This needs discussion with your surgeon and obstetrician, as a caesarean delivery may be advised to protect the repair.

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Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.