Anterior anal sphincter repair for fecal incontinence: Good longterm results are possible.

Background: Anterior anal sphincter repair (ASR) is standard treatment for fecal incontinence resulting from an obstetrically damaged anal sphincter. Longterm results of repair have generally been shown to be poor. This review of single-unit series aimed to determine longterm outcomes of primary ASR for patients with fecal incontinence from obstetrically damaged anal sphincter.

A new method of assessing anal sphincter integrity using inverted vectormanometry.

Purpose: Vectorgraphy as an integrated mapping of radial pressure profiles of the anal canal has been used to attempt identification of pressure-related defects with doubtful reliability since vectorgraphs bear no resemblance to endoanal ultrasound scans at similar levels in the anal canal. This study aimed to devise a technique to enable vectorgraphy to be more representative of sphincter function and integrity.

Methods: Vectormanometry was performed in 50 patients with anorectal disorders using an Arndorfer pneumohydraulic system.

Early results of a rotational flap to treat chronic anal fissures.

Background: Treatment of anal fissures has changed dramatically in the past decade. Only a few fail to respond to medical therapy. Sphincterotomy and anal dilatation have fallen out of favour due to the risk of incontinence.

Sacral nerve stimulation for faecal incontinence.

Faecal incontinence is a common problem. Conservative measures are effective in a significant proportion of patients. Failure of conservative management has until recently meant recourse to surgical intervention.

Rectal irrigation for relief of functional bowel disorders.

This article examines the use of rectal irrigation for the symptomatic relief of functional bowel disorders in certain groups of patients. The authors undertook a study of 80 patients and conclude that it is a valuable treatment for some patients.

Anal sphincter injury, fecal and urinary incontinence: a 34-year follow-up after forceps delivery.

Purpose: This study was designed to determine the long-term outcome of forceps delivery in terms of evidence of anal sphincter injury and the incidence of fecal and urinary incontinence.

Methods: Women who delivered in 1964 were evaluated by using endoanal ultrasound, manometry, and a continence questionnaire. Women delivered by forceps were matched with the next normal delivery and elective cesarean delivery in the birth register.

Rectoanal reflex parameters in incontinence and constipation.

Purpose: The transient relaxation of the internal anal sphincter in response to rectal distention is believed to play an important role in the continence mechanism. Most anorectal physiology laboratories merely report the rectoanal inhibitory reflex as being either present or absent. This study aimed to assess the parameters of the rectoanal inhibitory reflex in incontinent and constipated patients and healthy control subjects, in an attempt to analyze differences in internal anal sphincter function in these groups.