Functional outcome of total anorectal reconstruction: incontinence or constipation?

Background And Aims: Besides incontinence, constipation is important after TAR. We aimed at evaluating their correlation and role in functional outcome.

Materials And Methods: 81 diaries in 16 patients (up to 8 years) were assessed, by a specific scoring system, regarding incontinence and evacuation. In the overall series and in three postoperative time groups, the correlation between the two items, their mean scores and relative score rates (% of the maximum possible scoring) were calculated.

Results: The Spearman correlation coefficient in all assessments was -0.128. According to timing, it was: 0.468 (short term), -0.036 (mean term) and -0.69 (long term). Incontinence was more disabling than evacuation; constipation occurred more frequently. Incontinence improved over time; constipation did not substantially change.

Conclusions: Current criteria for functional assessment do not describe the true conditions after TAR and their variations over time. Profound consideration is necessary before announcing ultimate judgements on TAR.