Randomized trial of internal anal sphincter plication with pelvic floor repair for neuropathic fecal incontinence.

Abstract

This study was designed to examine the role of adjuvant internal anal sphincter plication in women with neuropathic fecal incontinence undergoing pelvic floor repair. We completed a randomized trial with symptomatic and physiologic assessment before and after surgery. There was no symptomatic advantage of adding internal sphincter plication; the mean improvement of functional score was 3.61 +/- 1.82 (standard deviation; P < 0.01) following pelvic floor repair alone compared with 2.80 +/- 1.66 (standard deviation; P < 0.01) when adjuvant internal and sphincter plication was added. The addition of internal sphincter plication was associated with a significant fall in maximum anal resting and squeezing pressures (P < 0.01). Addition of internal sphincter plication is not advised in women with neuropathic fecal incontinence treated by pelvic floor repair.