New methods of surgical correction of the puerperal anal sphincter insufficiency
Musaev, K.N.; Mamedov, M.M.; Alieva, E.M.
Khirurgiia 2010(12): 77-81
2010
ISSN/ISBN: 0023-1207 PMID: 21311478 Document Number: 642214
Treatment results of 612 patients aged from 17 to 71 years, with benign perineal diseases were analyzed. The rectovaginal fistula was diagnosed in 84 (13,7%), puerperal anal sphincter insufficiency - in 88 (14,4%) and rectocele was diagnosed in 139 (22,7%) of patients. 237 (38,7%) cases of perineal ruptures were analyzed retrospectively and 64 (10,5%) acute ruptures were analyzed prospectively. The suggested modified levatoroplasty includes the dissection of the proper fascia of the puborectal muscle, followed by the placation of the anterior muscle wall of the rectum and the posterior fascial sheet. After secure fixation of the first suture line, the second line sutures are applied on muscle tissue using monofilament resorbable material. The third line of the sutures connects anterior sheets of the proper fascia of the levators. Long-term follow up results were obtained in 80 (95,2%) of the operated patients. 63 patients reported excellent results, sphincter function had improved in 15 patients and operation had no effect in 2 cases.