Sphincter-levatorplasty as a method for correcting anal incontinence in women. Review

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Abstract

Background: Anal incontinence is a common problem in women who have suffered perineal trauma during childbirth. Symptoms of anal incontinence are socially disabling and significantly reduce quality of life.

Key findings: Current understanding of anal incontinence necessitates in-depth knowledge of the functioning of the rectal sphincter apparatus and diagnostic and therapeutic approaches to this problem. Surgical treatment of anal sphincter insufficiency includes various sphincteroplasty options, including restoration of the levator ani muscle. The long-term effectiveness of surgical correction of sphincter insufficiency varies; early and detailed diagnosis of muscle defects and functional impairments improves treatment outcomes, allowing for the development of an individualized, multimodal treatment approach. Alternative techniques (sacral neuromodulation, artificial sphincter implantation, and graciloplasty) are used in cases with severe damage, anal sphincter denervation, and in cases where other techniques have proven ineffective.

Conclusion: Modern approaches to sphincteroplasty focus on restoring anatomy and function, taking into account individual characteristics, with the choice of technique based on a balance between its benefits and potential risks.

About the authors

Evgeny Y. Glukhov

Ural State Medical University, Institute of Pediatrics and Reproductive Medicine; Center for Reconstructive Gynecology «Women’s Clinic»

Author for correspondence.
Email: 9222241411@mail.ru
ORCID iD: 0000-0003-3899-8382

Dr. Sci. (Med.), Chief Physician, Professor, Department of Obstetrics and Gynecology with a Course in Medical Genetics

Russian Federation, Yekaterinburg; Yekaterinburg

Artem G. Khizadze

Center for Reconstructive Gynecology «Women’s Clinic»

Email: khizadze.artem@gmail.com
ORCID iD: 0009-0006-9542-5184

Obstetrician-Gynecologist

Russian Federation, Yekaterinburg

Tatyana F. Kurkova

Center for Reconstructive Gynecology «Women’s Clinic»

Email: kurkovagyn@ya.ru
ORCID iD: 0009-0009-6360-9044

Obstetrician-gynecologist, Ultrasound Diagnostics Specialist

Russian Federation, Yekaterinburg

Victoria E. Glukhova

Ural State Medical University, Institute of Pediatrics and Reproductive Medicine; Center for Reconstructive Gynecology «Women’s Clinic»

Email: gluhovav17@mail.ru
ORCID iD: 0009-0006-1656-5411

Head of the Ultrasound Diagnostics Department

Russian Federation, Yekaterinburg; Yekaterinburg

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