Management and outcomes of anal sphincter injuries

Background: We aimed to examine surgical procedures

and outcomes of anal sphincter injuries (ASI).

Methods: Te data of 34 patients who operated due to grade

3–4 anal sphincter injury between 2010–2021 were analyzed.

Patients’ demographic features, complications, Wexner incontinence score and quality of life were evaluated.

Results: Te mean age of patients was 35.8 and the F/M

ratio was 23/11. Te etiopathogenesis of ASI were obstetric

injury 19, iatrogenic 6, drill-cutting tool injury 5, car accident 3,

and gunshot injury 1 respectively. 79.4 % of the patients didn’t

have anal tone at admission. 85.3 % had 3rd degree anal laceration. Overlapping sphincteroplasty was the most used method

and in addition, 20.6 % of the patients underwent colostomy.Complications were wound infection 14.7 %, wound dehiscence

8.8 %, fecal incontinence %5.8, urinary incontinence 5.9 %, anal

stricture, rectovaginal fstula, and the mortality rate was 2.9 %.

At mean follow-up of 35.8 months, the Wexner score was 3.59. A

low Wexner score increases the quality of life.

Conclusions: Te best results were obtained in obstetric

injuries, with a continence success rate of 75.9 %. Hospitalization time and complication rate are lower in patients with colostomy. In ASI, overlapping sphincteroplasty is the current surgical technique because of its good functional results.

Keywords: Anal sphincter injury, Overlapping repair