Faisal Siddiqi, Mirza Arshad Beg, Aisha Qamar, Areeba Abdullah.
Effect of lateral sphincterotomy on fecal and flatus incontinence.
Pak J Surg Jan ;34(3):188-91.

Introduction and Rationale: Lateral internal sphincterotomy is an effective treatment for chronic anal fissures; however, the risk of incontinence has generated interest in pharmacologic approaches that are far less effective and may be poorly tolerated. This study was done to objectively define the risk of incontinence with sphincterotomy using the fecal incontinence severity index and assess the implications for quality of life using the fecal incontinence quality of life scale. This study was undertaken to obtain local data as there is little available local data. This would help in better counselling of patients and would serve as an impetus for further research on subject Objective: To assess the frequency of fecal incontinence and flatus incontinence in patients undergoing sphincterotomy. Material and Methods: This study was designed to assess the long-term outcomes and quality of life of patients who have under-gone lateral sphincterotomy for chronic anal fissure. The medical records of patients who under-went this operation between 2015-2016 were reviewed. A questionnaire was filled by contacting patients on phone to assess their current status, along with the fecal incontinence and stool incontinence. Study design: Retrospective cohort study Settings: Department of general Surgery, Liaquat National Hospital and Medical College Duration of study: From January 2015 to December 2016, Sample Size: after checking with the records a total of 60 patients were operated during the study period. Out of which 39 patients responded and gave consent for being part of the study. Data collection:the inpatient and OPD record were reviewed of all the patients from January 2015 to December 2016 and were interviewed. The complete data of individual patients was collected and computed . Results: A total of 60 patients were recruited after fullfilling the inclusion criteria. After initial information a total of 39 patients agreed to the research proposal and were interviewed, 27 males and 12 females. The largest group of patients were from 35-40 years age group with minimum 19 and maximum 60 years old. A total of 30% of patients reported as having occasional flatulence incontinence. 32% of patients reported occasional stool incontinence . None of the respondents reported total incontinence. None of the respondents reported total loss of anal function. There were no recurrences. Conclusion: Flatulence and fecal incontinence after lateral sphincterotomy is a serious issue. Quality of life issues need to be addressed in further studies .

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