Gleditsch D, Nesbakken A, Nygaard K
Gastroenterologisk seksjon Kirurgisk klinikk Aker sykehus 0514 Oslo.
Tidsskr Nor Laegeforen. 2001 Jun 20;121(16):1908-10.
Anal incontinence in young women is often caused by sphincter rupture from obstetric injury or anal fistula surgery.
From 1992 to 1997, 17 women were operated for anal sphincter injury at Aker University Hospital, Oslo, Norway. Data were obtained retrospectively from patient files.
In 13 patients, the anal incontinence was caused by obstetric injury and in four by anal fistula surgery. In all patients the external anal sphincter was repaired with overlap technique. In addition, plication of the puborectalis muscle was performed in 15 patients, perineoplasty in eight, vaginoplasty in one and operation for genital prolapse in one. Nine patients had a temporary loop sigmoidostomy. 12 of 16 patients for whom postoperative symptoms had been recorded, reported improved anal continence. Eight of these had complete anal continence, whereas four still experienced some incontinence for gas and loose stools. On clinical examination, 11 patients had normal resting sphincter pressure and voluntary sphincter contraction. Six had weak voluntary contraction; two of these had normal resting sphincter pressure.
Traumatic anal sphincter injuries in young patients can seriously impair anal function. Results of surgical treatment are satisfactory in most patients.
年轻女性的肛门失禁通常由产科损伤或肛瘘手术导致的括约肌破裂引起。
1992年至1997年，挪威奥斯陆阿克大学医院对17名女性进行了肛门括约肌损伤手术。数据通过回顾患者病历获得。
13例患者的肛门失禁由产科损伤引起，4例由肛瘘手术引起。所有患者均采用重叠技术修复肛门外括约肌。此外，15例患者进行了耻骨直肠肌折叠术，8例进行了会阴成形术，1例进行了阴道成形术，1例进行了生殖器脱垂手术。9例患者进行了临时性乙状结肠造瘘术。在记录了术后症状的16例患者中，12例报告肛门失禁情况有所改善。其中8例实现了完全肛门失禁，而4例仍存在一些气体和稀便失禁的情况。临床检查显示，11例患者静息时括约肌压力和自主括约肌收缩正常。6例自主收缩较弱；其中2例静息时括约肌压力正常。
年轻患者的创伤性肛门括约肌损伤会严重损害肛门功能。大多数患者的手术治疗效果令人满意。
