Urogynecology and Pelvic Surgery

Sphincteroplasty Procedure

What is a sphincteroplasty?

Sphincteroplasty is a procedure used to correct fecal incontinence, the loss of normal bowel control.This happens when the muscles or nerves used for bowel control don’t work properly. The main muscle is the anal sphincter, which has two parts:

• Internal anal sphincter, which squeezes shut during sleep to keep gas and liquid from coming out unexpectedly. You cannot control this muscle.
• External anal sphincter, which surrounds the internal anal sphincter. You can control this muscle;

If these muscles or nerves are injured, it is difficult to control your bowls. The goal of sphincteroplasty is to repair the muscles and restore normal function of the anal sphincter.

This procedure is most effective when performed with five years of the initial injury, otherwise, the risk of symptoms reoccurring is very high.

How is the procedure performed?

After you are put under general anesthesia, your surgeon will make an incision (cut) between the rectum and vagina so they can get to the anal sphincter. Once the sphincter is identified, the surgeon will stitch (sew) sphincter muscle to restore the muscle function all the way around the rectum.

What can I expect from sphincteroplasty?

You may be asked to have an endoanal ultrasound, which uses sound waves to look at the sphincter and identify where it is weak or injured. You’ll have a preoperative visit to discuss what to expect with your doctor and undergo some basic lab work. If you need surgical clearance or prior authorization, you’ll need to get this before surgery.

Sphincteroplasty takes less than an hour. If you are having other pelvic issues that require surgery, those procedures may be done at the same time. You typically will stay overnight in the hospital.

What is my recovery time?

Most patients report mild pain with sphincteroplasty. You can expect some activity restrictions for 6 weeks, but many patients can return to a normal routine shortly after surgery. Activity restrictions include:

• No heavy lifting of more than 10 pounds
• No baths or soaking (showers are OK)
• No sexual intercourse
• No driving while on narcotic pain medications

What are the risks of the procedure?

The risk of complications from sphincteroplasty is typically very low. As with any procedure, there is a risk of anesthesia problems, pain, bleeding, infection, blood clots or damage to nearby organs. Risks specific to sphincteroplasty include:

• Breakdown of the incision or repair
• Local infection
• Recurrence of symptoms

Will my insurance company cover the procedure?

Check your insurance plan benefits to see if your policy covers sphincteroplasty. If it does, our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier.