Long-term Fecal incontinence after lateral internal sphincterotomy for anal fissure

Abstract

The background and purpose of the study An anal fissure is a common benign anal condition. The gold standard treatment is lateral internal sphincterotomy (LIS), and this procedure carries a risk of incontinence. The aim of this study is to determine the long-term risk of faecal incontinence after LIS. Method All patients who had LIS for chronic anal fissure between the years 2004 until 2010 were interviewed by phone and assessed for sphincter function (incontinence) using Wexner fecal incontinence score (WIS). Results Fifty-nine patients (34 females, 57.6%) with a mean follow-up duration of 10.6 years (range 8 – 15 years) were interviewed. Twelve patients (20.3 %) had a WIS score of one or more. The majority of the patient noticed the change in sphincter function years after the operation. There was no association between vaginal delivery and the WIS score result Conclusion The long-term risk of abnormal sphincter function after LIS appears to be higher than expected especially in the presence of multiple vaginal deliveries or systemic diseases such as Diabetes mellitus. A larger prospective study is required to establish a correct risk of incontinence in the long term.