BACKGROUND The abscesses and anal fistulas represent about 70% of perianal suppuration, with an estimated incidence of 1/10000 inhabitants per year and representing 5% of queries in coloproctology. AIM To evaluate the effectiveness of the interesphincteric ligation technique of the fistulous tract in the treatment of anal fistula. METHODS The records of eight patients who underwent this tec...

The aim of this study was to assess the efficacy of fissurectomy with skin advancement flap in healing chronic anal fissures without hypertonia of the internal anal sphincter. Twenty-six consecutive patients who failed healing after well-practiced topical medical therapy were enrolled. Anorectal manometry was performed preoperative and 6 months postoperatively. All patients were treated with fi...

Studies were carried out in 15 normal subjects and 14 patients with idiopathic faecal incontinence to test whether a rectoanal flap valve could be responsible for maintaining faecal continence in man. Intraluminal pressures were recorded from the rectum and from three sites in the anal canal during serial increases in intra-abdominal pressure, produced by forced expiration into a sphygmomanomet...

The latency of the response in the external anal sphincter muscle following transcutaneous stimulation of the cauda equina at the L1 vertebral level was measured in nine women with neurogenic faecal incontinence (mean 7.3 SD 0.7 ms) and 11 normal subjects (mean 5.6 SD 0.6 ms) (p = 0.01). There was no difference in conduction velocity between the L1 and L4 vertebral levels thus supporting the su...

In 40 women with idiopathic (neurogenic) faecal incontinence, 20 of whom also had stress urinary incontinence, single fibre EMG studies showed an increased fibre density in the external anal sphincter muscle. All these patients showed excessive descent of the pelvic floor on straining. The mean terminal motor latencies in the pudendal and perineal nerves, measured by a digitally-directed intrar...

The motor unit fibre density in the external anal sphincter muscle has been measured in 13 normal subjects aged 18 to 78 years, and in 14 patients with ano-rectal incontinence, aged 17 to 72 years. The mean fibre density in the normal subjects was 1.5 +/- 0.16, and in the incontinent subjects it was 2.17 +/- 0.28 (p less than 0.001). These findings provide support for the suggestion that ano-re...

BACKGROUND This study was undertaken to determine the efficacy and safety of subcutaneous lateral internal sphincterotomy (SLIS) for chronic anal fissure by assessing the relief of defecatory pain, duration of wound healing and associated complications such as bleeding, infection, and anal incontinence. METHODS This descriptive case series was carried out at the Department of Surgery, Pakista...

INTRODUCTION More than 80% of patients with full-thickness rectal prolapse have co-existing fecal incontinence. Choosing the ideal surgical strategy is always a difficult task. We combined an Altemeier rectosigmoid resection with anal dynamic graciloplasty to provide a functional neosphincter. We found no published reports describing this surgical association. CASE PRESENTATION We report the ...