Anal Sphincter Evaluation & Repair
The anal sphincter is a ring of muscle that closes at the bottom of the anus and is partially responsible for controlling bowel function. When the muscle is damaged or weakened, often during childbirth, it can result in incontinence.
In order to diagnose the cause of the damaged sphincter, a physician may use one of the following tests:
- The doctor will insert a finger into the rectum to assess the strength of the muscles.
- A balloon filled with water is inserted into the rectum. The patient then rids the balloon of water in the bathroom while being timed.
- X-rays or MRIs
- Scopes like colonoscopy or manometry to provide images inside of the rectum
If the incontinence is caused by damage to the sphincter muscle, two procedures can alleviate symptoms:
- sphincteroplasty (sphincter repair)
- sacral nerve stimulation
Sphincteroplasty (sphincter repair)
Prior to surgery, patients receive an enema to clear the bowels. During the procedure, the weakened area is discovered and freed from any attached scar tissue. The healthy muscles are overlapped and sewn together with stitches to tighten the sphincter.
Sacral nerve stimulation
Electronic impulses directed at the spine help coordinate the impulses from the brain to the bowel and sphincter muscles.
During the surgery, your physician will implant a lead wire connected to a temporary device (like a pacemaker) that sends impulses to the sacral nerve. It will be placed near the base of the spine.
There is an initial testing phase that lasts a couple of weeks to make sure the device is working. After this time, a permanent device is connected. To stop the therapy, the device must be removed permanently.