Repair of anal stricture and mucosal ectropion with Y-V or pedicle flap anoplasty.

Cicatricial stenosis and mucosal ectropion of the anal canal are disabling complications of anal surgery or disease and are extremely difficult to manage. Perusal of the literature reveals minimal consensus as to the most successful way to surgically manage patients with these conditions. During a 4-year period, we managed 19 patients who had anal stenosis (n = 14) or anal ectropion (n = 5). Eighteen of these patients had prior anal rectal surgery. We employed a Y-V anoplasty or advancement diamond-shaped pedicle flap and obtained satisfactory to excellent results in all patients. Concurrent lateral internal sphincterotomy was also employed in selected patients who had a fibrotic muscular component contributing to the stenosis. Based on our cohort of patients, we believe the pedicle skin flap technique is slightly superior to the Y-V anoplasty in functional and cosmetic results.