Prevalence of Transient Anal Incontinence in Patients Undergoing Lateral Sphincterotomy for Chronic Anal Fissure: An Observational Study

• Main Authors: Hrishikesh Maruti Pachpute, Kumar Subrahmanya Vashist, Devbrata Radhikamohan Adhikari
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2021-01-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: fissure healing rates; follow-up; postoperative pain relief
• Online Access: http://www.ijars.net/articles/PDF/2584/44453_CE[Ra1]_F(SHU)_PF1(AB_SHU)_PFA(SHU_AB)_PN(SHU).pdf

Introduction: Lateral Internal Sphincterotomy (LIS) is a timetested procedure of choice in cases of chronic anal fissure. Aim: To study the rates of transient anal incontinence, pain relief and healing rates of fissure in the operated patients. Materials and Methods: An observational study was done in the Department of Surgery at a tertiary hospital. A total of 62 subjects who underwent lateral sphincterotomy were included in a study duration of 12 months. Subjects were followed-up at four weeks and eight weeks interval after surgery and the following variables were assessed: prevalence of transient anal incontinence, pain relief and outcome in terms of healing of fissure. The descriptive data was studied using frequencies, percentages, mean and standard deviation and the association of study variables was studied with chi-square test and paired t-test. Results: In this study, 8.06% subjects (n=5) complained of anal incontinence at eight weeks postsurgery. Also, the anal incontinence at eight weeks (mean score=0.08±0.27) compared to that after four weeks (mean score=0.54±0.97) was significantly decreased (p<0.001). About 17.7% subjects (n=11) had pain at four weeks after surgery with mean pain score of 0.35±0.79 which had significantly improved (p<0.001) at eight weeks interval with only 6.4% subjects (n=4) complaining of pain with mean pain score of 0.08±0.3. The rates of healing of fissures at eight weeks (93.5%, n=58) increased as compared to four weeks follow-up (82.3%, n=51) though this increase in healing rates was not statistically significant (p=0.07). Conclusion: The severity and rates of anal incontinence and pain relief had significantly improved at eight weeks follow-up as compared to four weeks postsurgery. These results favour the idea that anal incontinence post lateral sphincterotomy is both transient and mild in most patients. Also, there is significant pain relief with good fissure healing rates at the end of eight weeks follow-up interval after surgery.