Martínez Hernández Magro Paulino, Godínez Guerrero Mario Alberto, Rivas Larrauri Eduardo, Herrera Huterer David, Barrón Vega Raúl
Hospital Guadalupano de Celaya.
Ginecol Obstet Mex. 2006 Aug;74(8):418-23.
Anal incontinence (IA) could be of idiopathic, congenital, neurological origin, or secondary to trauma. Obstetric trauma is the most common cause of the traumatic anal incontinence.
To analyze results of a group of patients with anal incontinence secondary to obstetric trauma, with overlapping sphincteroplasty.
All patients with anal incontinence secondary to obstetric trauma without neurological damage, between January 2002 to January 2006 were studied; all of them underwent overlapping sphincteroplasty. We evaluated improvement in incontinence score according Jorge and Wexner incontinence scale, pre and postoperatively as well as morbi-mortality rates.
16 patients, most of them with total anal incontinence, with preoperative values between 16 to 20 points at the Jorge and Wexner scale; 14 patients (87.5%) referred improvement in their values with 4 to 0 points postoperatively, two patients did not refer significant improvement, both of them with defects in both sphincters and loss of the 50% of the entire sphincteric complex. They were sent to bio-feedback therapy. There was not mortality. Seven patients (43.7%) had skin dehiscence.
Overlapping sphincteroplasty is an accurately technique for repair obstetric trauma injuries of the anal sphincter, with a success rate of 70 to 80%, and a low morbidity rate.
肛门失禁（IA）可能是特发性、先天性、神经源性的，或继发于创伤。产科创伤是创伤性肛门失禁最常见的原因。
分析一组产科创伤继发肛门失禁且行重叠式括约肌成形术患者的治疗结果。
研究2002年1月至2006年1月间所有产科创伤继发肛门失禁且无神经损伤的患者；所有患者均接受重叠式括约肌成形术。我们根据豪尔赫和韦克斯纳失禁量表评估术前和术后失禁评分的改善情况以及病死率和发病率。
16例患者，大多数为完全性肛门失禁，豪尔赫和韦克斯纳量表术前评分为16至20分；14例患者（87.5%）术后评分从4分改善至0分，2例患者未出现明显改善，这2例患者括约肌均有损伤且整个括约肌复合体50%缺失。他们被送去接受生物反馈治疗。无死亡病例。7例患者（43.7%）出现皮肤裂开。
重叠式括约肌成形术是修复产科创伤性肛门括约肌损伤的一种精确技术，成功率为70%至80%，发病率低。
