[Fecal incontinence following obstetrical injury; significance of damaged pelvic floor innervation and results of surgical treatment].

During the last 5 years 33 patients with faecal incontinence due to childbirth were investigated. Ages varied from 23 to 61 and duration of symptoms from 0.3 to 25 years. Anal manometry was performed in all patients and electromyography was performed in 21 cases. Twenty-seven patients underwent delayed sphincter repair. Continence was restored in 21 (81%). Post-operatively performed EMG in the patients who remained incontinent demonstrated severe denervation but sphincter mapping did not demonstrate muscle discontinuity. Continence improved in three patients within one year as results of reinnervation. Faecal incontinence after childbirth may be due to either obstetric rupture or denervation. Both disorders may coexist. Sphincter repair gives excellent results provided denervation is not present. Preoperative assessment by EMG is mandatory.