Anal sphincter is a ring of muscle that opens and closes at the bottom of your anus and plays a large role in controlling bowel function. When the muscle is damaged or weakened it can cause incontinence accidental loss of stool.
- Anorectal manometry – Inserts a tiny balloon filled with water into your rectum to test the pressure of anal sphincter muscles
- Colonoscopy – Takes pictures by using a thin, flexible tube (colonoscope) with an attached camera
- Digital rectal examination (DRE) – Manually assesses the strength of your anal sphincter muscles
- Defacography – Uses magnetic waves or X-rays to create high-definition pictures to see how well your pelvic muscles are working during a bowel movement
Fecal incontinence may occur temporarily during an occasional bout of diarrhea, but for some people, fecal incontinence is chronic or recurring. People with this condition may be unable to stop the urge to defecate, which comes on so suddenly that they don't make it to the toilet in time. This is called urge incontinence.
Another type of fecal incontinence occurs in people who are not aware of the need to pass stool. This is called passive incontinence.
Fecal incontinence may be accompanied by other bowel problems, such as:
• Gas and bloating
Anal sphincter can be damaged by a number of causes, including:
• Nerve damage, impacting your brain’s ability to get signals that your bowels are full
• Overstraining your bowels
• Trauma resulting from anal or rectal surgery
What is anal sphincteroplasty or anal sphincter repair?
It is a surgery done to repair the muscle that control bowel movement through the anus called the anal sphincter.
What causes bowel incontinence?
Dysfunction of the anal sphincter leads to bowel incontinence – a condition in which the ability to control (start or stop) passage of stool or bowel movements is lost. This leads to frequent soiling of clothes, general discomfort.
What is the role of anal sphincteroplasty or anal sphincter repair in bowel incontinence?
Anal sphincteroplasty or anal sphincter repair surgery includes cutting the non-functional muscles and joining the functional parts to form an intact sphincter which is continent.
What is the success rate of anal sphincteroplasty or anal sphincter repair?
In various studies, the success of the treatment is considered to vary between 70%-90% relief in symptoms, immediately after surgery; and 50-70% in long term (5-10 years).
What are the effects of getting anal sphincteroplasty or anal sphincter repair?
General anaesthesia causes drowsiness after surgery. Stool passage and urine passage causes discomfort for about 4 weeks or more. Sexual activities are to be refrained from for 6-8 weeks. Weight lifting and other such strenuous activities are not advisable after surgery.
What are pre- and post-operative precautions to be undertaken for anal sphincteroplasty or anal sphincter repair surgery?
Before the surgery, after thorough examination and investigations, enema is administered to clear the bowel. Surgery is performed under general anaesthesia. Post-surgery catheter is introduced to aid in passing urine. Mild pain, swelling and discomfort may be treated by painkillers. No dietary restrictions are followed, however, stool softens may be prescribed to ease stool passage for a few days. The dressing on he wound is changed frequently to prevent infection or exposure.
What are the complications of anal sphincteroplasty or anal sphincter repair?
Wound infections are most commonly seen complication, though rare in septic conditions. There is a chance or reversal or re-development of sphincter dysfunction in prone individuals. Susceptibility to bleeding during surgery is ruled out beforehand, along with assessment of heart condition.
What are the alternatives to anal sphincteroplasty or anal sphincter repair?
Initially, conservative management is employed to promote formation of formed stools, using anti-constipation medicines. Use of anal plugs is another method to close the anus. Amongst surgery, alternatives are augmenting surgeries which use grafts of muscle from the body in place of the sphincter. Postanal repair surgery can also be undertaken which strengthens the anal sphincteric muscle.