PURPOSE OF REVIEW There is a significant risk of anal incontinence in women who sustain a third or fourth degree tear of the external anal sphincter (EAS) at the time of delivery. Optimizing the surgical correction of these injuries should result in the best functional outcome for women. The purpose of this review is to examine recent evidence. RECENT FINDINGS The results of randomized trials...

Background: The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. Patients and methods: 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

Background: The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. Patients and methods: 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

OBJECTIVE To describe the effect of vaginal delivery with no clinically recognized sphincter tear on endosonographic anal sphincter morphology and sphincter pressure and to relate endosonographic results to anal sphincter pressure and anal incontinence score. STUDY DESIGN Thirty-two nullipara underwent anal endosonography and anal manometry in the third trimester of pregnancy, 2 weeks and 6 m...

OBJECTIVE To assess the efficiency of endorectal ultrasound (ERUS) in the study of chronic idiopathic anal pain (CIAP). MATERIAL AND METHOD This is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months duration. A complete colonoscopy was performed in all patients, which found n...

Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the...

PURPOSE The purpose of this study was to identify factors that have a negative impact on anal function after intersphincteric resection. METHODS We evaluated postoperative anal function in 96 patients with very lower rectal cancer who underwent intersphincteric resection by having patients fill out detailed questionnaires at 3, 6, 12, and 24 months after surgery. Univariate and multivariate a...

BACKGROUND The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. PATIENTS AND METHODS 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

Background: The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. Patients and methods: 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

BACKGROUND There is still considerable debate about the value of preoperative anorectal physiological parameters in predicting the clinical outcome after sphincteroplasty. Recently it has been reported that atrophy of the external anal sphincter can be clearly shown with endoanal magnetic resonance imaging (MRI). The aims of this study were to investigate the prevalence of external anal sphinct...