Anal Sphincteroplasty

Anal Sphincteroplasty

Anal sphincteroplasty is a methodology used to repair torn or debilitated anal sphincter muscles, the muscles that control faeces discharge.

Otherwise called anal sphincter repair, the procedure is usually used to treat faecal incontinence caused by anal muscles harmed amid parturition. The operation is conducted under general or local anaesthesia.

How is the Diagnosis Made?

• Diagnosing faecal incontinence includes taking a sufficient history from patients as the numerous causes, and side effects of faecal incontinence fluctuate. The doctor will regularly make inquiries to understand the seriousness of the side effects. This incorporates taking note of the recurrence of incontinence to gas, fluid, or solid stool. Doctors will frequently get some information about the capacity to detect the need for excretion.

The effect the manifestations are having on the patient's life will likewise be investigated. Doctors may utilise a scoring system to measure the seriousness of the indications.

• Ultrasound Probe

Anal ultrasound is a standout amongst the most widely recognised examinations. Amid this test, an ultrasound probe is embedded into the anal pathway. The ultrasound machine can create pictures which show the abnormalities in anal muscles.

• Anorectal Manometry

In this test, a pressure sensor is embedded into the anus to quantify the pressure inside the rear-end and rectum. This gives data on how well your muscles can contract, and also how well your rectum is working as a store for stool.

• Different tests are used to assess the faecal incontinence- colonoscopy, electromyography with testing of the pudendal nerves, and defecography.

What is the Surgical Procedure?

In this operation, bowel preparation is not mandatory. The surgeon asks the patient to pass stool before the surgery and come with an empty stomach and rectum. If the rectum still contains liquid stool, then it may escape and contaminate the part which is being operated.

Broad-spectrum perioperative antibiotics are given during the surgery.

A protective colostomy is only required in severe situations like sphincter tears are associated, fracture of the pelvis, laceration or perforation of the rectum. Pelvis fracture and injury may also happen together.

The patient is operated in the lithotomy position with the hips protruding down the operative table.

Postoperative Care and Prognosis Given to the Patient

• The patient can wash up the day after medical procedure yet ought to maintain a strategic distance from water for at least 2 weeks. The suture line should be disinfected 2 to 3 times each day, especially after defaecation.
• The post-surgery wound is secured with a cushion of the bandage.
• The patient is advised to use laxatives and paraffin oil from the day of the medical procedure. When the patient wants to pass stools, a bowel purge ought to be given at any time to pass stools without any problem.
• Usual eating routine can be resumed after the surgery.
• Adhesive and bulk-forming agents are given together with paraffin oil for 2 to 3 weeks.

What are Postoperative Complications?

Like any other surgical procedure, anal sphincteroplasty also has its own complications.

• Skin dehiscence
• Persistent incontinence.
• Sphincter suture leak
• Infection may occur in 1/3rd of the cases