Anal sphincter reconstruction.

Injury of the sphincter mechanism that is caused by trauma may be repaired if the operation is carried out without prolonged delay and if sufficient residual sphincter remains. Successful surgical reconstruction requires thorough preoperative evaluation, fastidious preoperative preparation, meticulous surgical technique, and vigorous postoperative management. When the operation is delayed or considerable tissue has been lost or if the patient is elderly and has a history of constipation or laxative abuse, direct repair is frequently unsuccessful.