Rectal lesions without anal sphincter trauma in childbirth are only sporadically described in literature. We describe the case of a 29-year-old primigravida who delivered a child in frank breech presentation. During the second stage of labour a foot presented transanally through a rectal laceration with intact anal sphincters. The laceration was repaired immediately after delivery in theatre. F...

The role of anal sensation in preserving continence was studied in nine healthy volunteers. Objective assessment of sphincter function by manometry and rectal saline infusion was carried out during topical anaesthesia of the anal canal using 5% lignocaine gel and during lubrication with the same amount of inert gel. Anaesthesia successfully abolished anal sensation and reduced both the amplitud...

Botulinum toxin can chemically denervate striated muscle. Botulinum toxin A (15 U) was used to treat ten patients with chronic anal fissure by injection in the internal sphincter. In seven patients, the lesion healed at 2 months after treatment; one relapsed at 3 months. In one patient the lesion healed at 1 month, but partly relapsed a month later. Mild faecal incontinence lasting for 1 day wa...

Endoanal ultrasound is now regarded as the gold standard for evaluating anal sphincter pathology in the investigation of anal incontinence. The advent of three-dimensional ultrasound has further improved our understanding of the two-dimensional technique. Endoanal ultrasound requires specialised equipment and its relative invasiveness has prompted clinicians to explore alternative imaging techn...

Obstetric trauma following childbirth is the primary cause of faecal incontinence in women. Injury to the anal sphincter complex is common: it has been clinically diagnosed in 0.4–2.5% of vaginal deliveries involving a mediolateral episiotomy and in up to 19% of cases of midline episiotomy. Studies using endoanal ultrasound have reported occult anal sphincter injury in up to 35% of women after ...

Anal fissure is a common disorder which may cause symptoms at any age. Internal anal sphincterotomy is the gold standard surgical treatment which lowers the resting anal pressure and effectively heals the majority of fissures. However the post operative period may be marked by surgical risks, complications and late incidence of incontinence that is some times permanent. These complications has ...

Anal dilatation in response to gentle parting of the buttocks has been advocated as a sign of sexual abuse in children, but nothing is known of the physiology of this response or its existence in normal subjects, in patients with spinal disease, and in patients with a weak sphincter and whether it can be elicited after training. To answer these questions we investigated the effect of parting th...

AIM: to assess late results of surgery for incomplete internal anal fistulas. PATIENTS AND METHODS: the prospective cohort study included 156 patients with in complete fistulas 2014-2017. RESULTS: efficacy treatment was obtained 132/147 (89.8%) patients, 106/117 (90.6%) revealed no incontinence (AI). Recurrence developed 15/147 (10.2%) cases and 11/147 (7.5%) — incontinence. Newly 7/117 (6.0%) ...