Continence disorders after anal surgery—a relevant problem?

@article{Ommer2008ContinenceDA,
  title={Continence disorders after anal surgery—a relevant problem?},
  author={Andrea Ommer and Frank Axel Wenger and Thomas-Marten Rolfs and Martin K. Walz},
  journal={International Journal of Colorectal Disease},
  year={2008},
  volume={23},
  pages={1023-1031}
}
SubjectAnal incontinence is a well-known and feared complication following surgery involving the anal sphincter, particularly if partial transection of the sphincter is part of the surgical procedure.MethodsThe literature was reviewed to evaluate the risk of postoperative incontinence following anal dilatation, lateral sphincterotomy, surgery for haemorrhoidal disease and anal fistula.ResultsVarious degrees of anal incontinence are reported with frequencies as follows: anal dilatation 0–50… 

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References

SHOWING 1-10 OF 120 REFERENCES
Frequency of Operative Trauma to Anal Sphincters: Evaluation With Endoanal Ultrasound
TLDR
This study includes 123 subjects who had undergone anorectal surgery in the past and were examined with endoanal ultrasound for various indications such as continence disorders, recurrent fistula, idiopathic perineal pain, or simple postoperative follow-up.
Anal sphincter reconstruction for incontinence due to non-obstetric sphincter damage.
TLDR
Anal sphincter reconstruction for non-obstetric anal incontinence produced good short-term results and two patients required further repair resulting in complete continence.
Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano
TLDR
It is concluded that anal dilatation results in sphincter damage in more than half of patients, but few of them develop anal incontinence.
Long-Term Outcomes after Anal Dilatation for Anal Fissure
TLDR
The incidence and severity of anal incontinence in those treated by anal dilatation is no different to that of the general population, and other treatment modalities should be evaluated over the longer term.
Concepts in pathogenesis and treatment of chronic anal fissure—a review of the literature
TLDR
Topical glyceryl trinitrate ointment and injection of botulinum toxin into the anal sphincter are advocated as the first-line treatment for chronic anal fissure and should be offered to patients with relapse and therapeutic failure of prior pharmacological treatment.
Reappraisal of partial lateral internal sphincterotomy
TLDR
Extended follow-up after partial lateral internal sphincterotomy demonstrates a higher complication rate than was seen in patients being followed for shorter periods, however, the complication of impaired fecal continence only occurred in 8 percent of the authors' patients, compared with 15 percent reported in the current literature, although using the same evaluative criteria.
Anal endosonographic evaluation after closed lateral subcutaneous sphincterotomy
TLDR
Anal endosonography is a useful method for evaluating the anatomic effectiveness of closed lateral subcutaneous sphincterotomy and its relationship to outcome with respect to anal fissure recurrence and postoperative anal incontinence.
Surgical repair of fecal incontinence. Correlation of sonographic anal sphincter integrity with subjective cure.
TLDR
There was no correlation between symptomatic relief and anal sphincter integrity as evaluated by physical and sonographic examination and the subjective cure rates of fecal incontinence were found.
Excision of Anal Fistula With Closure of the Internal Opening
TLDR
Manometric results suggest that this is associated with an impaired internal anal sphincter function, and surgery for anal fistula with excision and advancement flap has a fairly high initial recurrence rate but a good final success rate.
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