What is Anal Sphincter Repair?

Anal sphincter repair, also known as anal sphincteroplasty, surgically corrects a weak or torn anal sphincter. The anal sphincter is a ring of muscles that controls the opening and closing of the anus. A weak sphincter may be caused by nerve damage in the pelvic area, called pelvic neuropathy. Anal sphincter tears, on the other hand, are most commonly brought about by trauma during vaginal childbirth, surgery to correct anal fistulas (tiny tunnels that have formed in muscle or fatty layers around the anus), and hemorrhoid or anal wart removal.

Sometimes, sphincter injury is discovered during vaginal childbirth or surgery and is repaired during the same procedure. More often, however, the problem is not treated until it results in fecal incontinence, which is the inability to control bowel movement.

If the issue is a torn sphincter, an overlapping sphincter repair may be performed. In this procedure, an incision is made in the anus, and then one end of a damaged muscle is overlapped over another to form a complete ring. To correct fecal incontinence caused by a weak sphincter, the technique most frequently used is called post anal repair. An incision is made in the rear portion of the anus, and the muscles are plicated, or folded, to tighten and strengthen the sphincter.

Anal sphincter repair typically requires a hospital stay of three to seven days, and a recovery period of two to four weeks. Women who need this procedure and plan to have more children are advised to have a cesarean section (delivery through incision in the belly and womb), as vaginal childbirth may damage the repair done to the sphincter. Alternatively, they may wait until after they have finished having children to have the repair.

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