Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study
ABSTRACT BACKGROUND: The results from sphincteroplasty may worsen over time. Reseparation of the rectum and vagina/scrotum in conjunction with sphincteroplasty achieves good results. Improving the surgical effect of sphincteroplasty through perineal body reconstruction is crucial. OBJECTIVE: To...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
2021-01-01
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| Series: | São Paulo Medical Journal |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000100058&tlng=en |
| _version_ | 1818745227675959296 |
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| author | Mustafa Berkesoglu Tahsin Colak Mehmet Ozgur Turkmenoglu Ismet Han Ilter Kirmizi Gokhan Giray Akgul Ihsan Gunduz |
| author_facet | Mustafa Berkesoglu Tahsin Colak Mehmet Ozgur Turkmenoglu Ismet Han Ilter Kirmizi Gokhan Giray Akgul Ihsan Gunduz |
| author_sort | Mustafa Berkesoglu |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: The results from sphincteroplasty may worsen over time. Reseparation of the rectum and vagina/scrotum in conjunction with sphincteroplasty achieves good results. Improving the surgical effect of sphincteroplasty through perineal body reconstruction is crucial. OBJECTIVE: To evaluate the long-term results from anterior sphincteroplasty and perineal body reconstruction (modified sphincteroplasty) among patients with traumatic sphincter injury. DESIGN AND SETTING: Retrospective study among patients who underwent modified sphincteroplasty in a university hospital between January 2006 and December 2018. Fifty patients were evaluated in detail. METHODS: The following variables were evaluated: gender, age, additional disease status, time interval between trauma and surgery, surgical technique, duration of hospitalization, follow-up period after surgery, manometric values, electromyography results, magnetic resonance imaging scans, Wexner scores, satisfaction levels with surgery and surgical outcomes. RESULTS: The patients’ mean age was 44.6 ± 15.1 years. The median follow-up period was 62 months (range, 12-118). The mean Wexner scores preoperatively, postoperatively in first month (M1S) and at the time of this report (AAS) were 15.5 ± 3.2, 1.9 ± 3.15 and 3.9 ± 5.3, respectively. Although improvements in the patients’ mean Wexner scores became impaired over time, the postoperative Wexner scores were still significantly better than the preoperative Wexner scores (P = 0.001). CONCLUSION: Good or excellent results were obtained surgically among patients with traumatic sphincter injury. Performing perineal body reconstruction in addition to sphincteroplasty can provide better long-term continence. Surgical outcomes were found to be better, especially among patients younger than 50 years of age and among patients who underwent surgery within the first five years after trauma. |
| first_indexed | 2024-12-18T02:56:51Z |
| format | Article |
| id | doaj.art-ac60f0671a7f406fafeced6a9c83e0d7 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-18T02:56:51Z |
| publishDate | 2021-01-01 |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-ac60f0671a7f406fafeced6a9c83e0d72022-12-21T21:23:21ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94602021-01-011391586410.1590/1516-3180.2020.0467.02112020Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective studyMustafa Berkesogluhttps://orcid.org/0000-0002-5850-5592Tahsin Colakhttps://orcid.org/0000-0002-7253-5608Mehmet Ozgur Turkmenogluhttps://orcid.org/0000-0002-3461-6909Ismet Hanhttps://orcid.org/0000-0002-5556-7202Ilter Kirmizihttps://orcid.org/0000-0002-0132-6892Gokhan Giray Akgulhttps://orcid.org/0000-0002-0592-7521Ihsan Gunduzhttps://orcid.org/0000-0002-7835-7531ABSTRACT BACKGROUND: The results from sphincteroplasty may worsen over time. Reseparation of the rectum and vagina/scrotum in conjunction with sphincteroplasty achieves good results. Improving the surgical effect of sphincteroplasty through perineal body reconstruction is crucial. OBJECTIVE: To evaluate the long-term results from anterior sphincteroplasty and perineal body reconstruction (modified sphincteroplasty) among patients with traumatic sphincter injury. DESIGN AND SETTING: Retrospective study among patients who underwent modified sphincteroplasty in a university hospital between January 2006 and December 2018. Fifty patients were evaluated in detail. METHODS: The following variables were evaluated: gender, age, additional disease status, time interval between trauma and surgery, surgical technique, duration of hospitalization, follow-up period after surgery, manometric values, electromyography results, magnetic resonance imaging scans, Wexner scores, satisfaction levels with surgery and surgical outcomes. RESULTS: The patients’ mean age was 44.6 ± 15.1 years. The median follow-up period was 62 months (range, 12-118). The mean Wexner scores preoperatively, postoperatively in first month (M1S) and at the time of this report (AAS) were 15.5 ± 3.2, 1.9 ± 3.15 and 3.9 ± 5.3, respectively. Although improvements in the patients’ mean Wexner scores became impaired over time, the postoperative Wexner scores were still significantly better than the preoperative Wexner scores (P = 0.001). CONCLUSION: Good or excellent results were obtained surgically among patients with traumatic sphincter injury. Performing perineal body reconstruction in addition to sphincteroplasty can provide better long-term continence. Surgical outcomes were found to be better, especially among patients younger than 50 years of age and among patients who underwent surgery within the first five years after trauma.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000100058&tlng=enAnal canalFecal incontinencePerineumSurgery [subheading]Anal sphincterAnal incontinenceSphincteroplasty. |
| spellingShingle | Mustafa Berkesoglu Tahsin Colak Mehmet Ozgur Turkmenoglu Ismet Han Ilter Kirmizi Gokhan Giray Akgul Ihsan Gunduz Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study São Paulo Medical Journal Anal canal Fecal incontinence Perineum Surgery [subheading] Anal sphincter Anal incontinence Sphincteroplasty. |
| title | Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study |
| title_full | Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study |
| title_fullStr | Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study |
| title_full_unstemmed | Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study |
| title_short | Long-term results from modified sphincteroplasty in patients with traumatic sphincter injury: a retrospective study |
| title_sort | long term results from modified sphincteroplasty in patients with traumatic sphincter injury a retrospective study |
| topic | Anal canal Fecal incontinence Perineum Surgery [subheading] Anal sphincter Anal incontinence Sphincteroplasty. |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000100058&tlng=en |
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