Repairing muscle tears

Sphincteroplasty is a surgical procedure to reconstruct the anal sphincter muscles after a trauma or injury has occurred, for instance, during childbirth.

BestTreatments from the BMJ: Anal tears (anal fissure)

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Muscle repairs not due to tears

Post-anal repair is not very common. It is sometimes used to fix sphincter problems that don't involve tears but where the pelvic floor is weak.

Anterior levatorplasty with post-anal repair is called total pelvic floor repair. This is used to fix weakness and sagging in the pelvic floor muscle as well as weakness of the anal sphincter

Prolapse repair

Surgery is done to fix prolapses, such as intussuption (rectum sliding in on itself) or rectocele (rectum buldging into the vagina).

In cases of obstructed defecation, a stapled transanal rectal resection (STARR) surgical procedure can be performed where redundant mucosa are removed and the remaining parts are stapled together.

NICE: Stapled transanal rectal resection (information for the public)

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Colostomy

This is when part of the colon is brought to the surface of the abdomen where a bag is attached. Colostomy can be either temporary or permanent. Good skin care is required to avoid infection of the skin around the site of the exit point, called a stoma.

Colostomy Association

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Enema operation

The antegrade continence enema (ACE) is used to empty the bowel. It involves connecting the large bowel to the abdominal wall through the appendix where an enema or wash can be administered.

Other surgeries

Transanal radiofrequency is where radiofrequency is used to create thermal lesions in the muscle. In healing, these lesions create scar tissue and cause the muscle to contract.

Artificial bowel sphincter is an implanted device. It creates a cuff around the anus which is filled with fluid. Through a small pumping system, the person can fill or empty the cuff allowing faeces to pass.

NICE: Artificial anal sphincter

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Stimulated graciloplasty or dynamic graciloplasty is a surgical procedure where a muscle from the leg is wrapped around the anus to form a new sphincter. Electrical stimulation is then used to help the implanted muscle function.