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Invited Commentary

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Pelvic Floor Disorders

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Abstract

Dr Pfeifer has clearly and expertly outlined the methods, techniques, results, and morbidity of sphincter repair and postanal repair in Chapter 28. Although the initial reported success rates with sphincter repair were in excess of 90%, several long-term studies have revealed those success rates are in the vicinity of 15% to 30% [1–4]. There are certain factors that may be predictive of failure, including pudendal neuropathy. However, prior sphincter repair does not appear to auger for failure of subsequent sphincter repair [5]. Because of the unfortunately poor long-term efficacy of this operation, it is certainly not a panacea. Current debate centers around whether the anal sphincters should be repaired, as, although the procedure may improve incontinence, it may also induce significant scarring. If scarring is produced and the result is suboptimal, then subsequent procedures such as stimulated graciloplasty, artificial bowel sphincter, and even sacral nerve stimulation may not be as successful.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner MD

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  1. Steven D. Wexner MD
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Editors and Affiliations

  1. Pelvic Floor Unit and Colorectal Service 1st Department of General Surgery, Regional Hospital, Treviso, Italy

    Giulio Aniello Santoro (Head) (Head)

  2. Department of Pediatric Radiology Children’s Teaching Hospital, Skubiszewski Medical University of Lublin, Lublin, Poland

    Andrzej Paweł Wieczorek

  3. Diagnostic Imaging, Princess Grace Hospital, London, UK

    Clive I. Bartram

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Wexner, S.D. (2010). Invited Commentary. In: Santoro, G.A., Wieczorek, A.P., Bartram, C.I. (eds) Pelvic Floor Disorders. Springer, Milano. https://doi.org/10.1007/978-88-470-1542-5_48

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  • DOI: https://doi.org/10.1007/978-88-470-1542-5_48

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1541-8

  • Online ISBN: 978-88-470-1542-5

  • eBook Packages: MedicineMedicine (R0)

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