Anal sphincter repair is an operation performed to repair a gap or deficit in the anal sphincter muscle; causes include injury, childbirth and anal fistula and or abscess involving the sphincter muscle. Sphincter impairment is one of the possible causes of faecal incontinence.

What other tests are necessary before this operation?

Initial consultation involves assessment of symptoms and examination. Other tests may include colonoscopy, studies of the anal sphincter to look at its structure and function (anorectal physiology and ultrasound), and x-ray studies that look at how well your large bowel works and how well supported your pelvic organs are during the process of emptying your bowels.

What does the operation involve?

The operation is performed under a general anaesthetic. It can be a stand-alone procedure but is most often done via a per anal approach at the time of other procedures as indicated, ie; haemorrhoidectomy and delorme procedure.

What are the risks?

There are small risks associated with any operation. Pre-operative assessments are made of any heart or lung conditions, as well as any coexisting medical conditions.

• Bleeding is rare in this type of surgery, patients may notice small amounts of blood draining from the wound, this usually settles in the first week.

• Wound infection is rare, symptoms may present as increased pain, bleeding, purulent discharge and fever, treatment may require an antibiotic and occasionally another operation to debride ‘clean’ the wound and correct any healing deficit.

• Patients may experience some minor bowel incontinence in the recovery period mainly due to local postoperative swelling, which settles gradually. 

Post-Operative Information

Discharge is usually the next day post op. Take home medications include regular Panadol; a stronger analgesia may be prescribed if required.

Benefiber (soluble fiber supplement) to take for 2-4 weeks to soften stools, the laxative Macrogol may also be taken as needed to help pass stools easily and avoid straining.

Avoid heavy lifting and excessive physical activity for about 6 weeks. 

Warm baths (Sitz baths) or showers after bowel motions help to keep the area clean and decrease pain and discomfort, about a tablespoon of salt can be added to bath.

As comfort level improves patients can commence some pelvic floor physiotherapy to help strengthen the muscles. 

For pelvic floor training techniques, please refer to bladderbowel.gov.au

Pelvic floor training for men - click HERE.

Pelvic floor training for women - click HERE.