Volume : 40 Issue : 3 Year : 2021
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pelviperineology. 2021; 40(3): 154-160 | DOI: 10.34057/PPj.2021.40.02.2021-8-4

Reconstructive surgery in 1,014 consecutive patients with complex sphincter ani rupture: principles and practice

Kees WAALDIJK1
1National Obstetric Fistula Center, Babbar Ruga, Nigeria


Objective: To describe the anatomic fecal continence mechanism, the mechanism of action, the complex trauma itself and the reconstructive principles and to present the evidence-based results in a large scale study of a comprehensive approach to the repair of complex sphincter ani rupture.

Materials and Methods: A total of 1,014 women with sphincter ani rupture were operated by a personal operation technique exactly in the opposite order of the trauma, first the internal sphincter, then the external sphincter in end-to-end fashion and lastly the perineal body with meticulous attention to detail.

Results: At first attempt the sphincter ani rupture had healed in 924 patients (91%) and at final attempt 988 patients (98%) had healed with incontinence in 10 and a failure was noted in 26 patients out of whom 10 were inoperable.

Conclusion: This operation technique is highly effective since the normal functional anatomy is reconstructed and restored along with the physiology. It can be recommended to the low-, middle- and high-income world as evidence-based standard.


Cite This Article

WAALDIJK K. Reconstructive surgery in 1,014 consecutive patients with complex sphincter ani rupture: principles and practice. 2021; 40(3): 154-160

Corresponding Author: WAALDIJK K.

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