2006, Number 08
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Ginecol Obstet Mex 2006; 74 (08)
Anal incontinence caused by an obstetric trauma. Experience with the technique of overlapping sphincteroplasty
Martínez HMMP, Godínez GMA, Rivas LE, Herrera HD, Barrón VR
Language: Spanish
References: 27
Page: 418-423
PDF size: 315.98 Kb.
ABSTRACT
Introduction: Anal incontinence (IA) could be of idiopathic, congenital, neurological origin, or secondary to trauma. Obstetric trauma is the most common cause of the traumatic anal incontinence.
Objective: To analyze results of a group of patients with anal incontinence secondary to obstetric trauma, with overlapping sphincteroplasty. Patients and methods: All patients with anal incontinence secondary to obstetric trauma without neurological damage, between January 2002 to January 2006 were studied; all of them underwent overlapping sphincteroplasty. We evaluated improvement in incontinence score according Jorge and Wexner incontinence scale, pre and postoperatively as well as morbi-mortality rates.
Results: 16 patients, most of them with total anal incontinence, with preoperative values between 16 to 20 points at the Jorge and Wexner scale; 14 patients (87.5%) referred improvement in their values with 4 to 0 points postoperatively, two patients did not refer significant improvement, both of them with defects in both sphincters and loss of the 50% of the entire sphincteric complex. They were sent to biofeedback therapy. There was not mortality. Seven patients (43.7%) had skin dehiscence.
Conclusions: Overlapping sphincteroplasty is an accurately technique for repair obstetric trauma injuries of the anal sphincter, with a success rate of 70 to 80%, and a low morbidity rate.
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