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Long-term functional results of transvaginal anal sphincter repair for faecal incontinence; a retrospective cohort study.
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  • Frida Carswell,
  • Peter Dwyer,
  • Ariel Zilberlicht,
  • James Alexander,
  • Madhu Bhamidipaty,
  • Alison De Souza,
  • Alex Wong,
  • James Keck,
  • Lore Schierlitz
Frida Carswell
Mercy Hospital for Women

Corresponding Author:[email protected]

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Peter Dwyer
Mercy Hospital for Women
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Ariel Zilberlicht
Carmel Medical Center
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James Alexander
The Royal Hospital for Women
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Madhu Bhamidipaty
St Vincent Hospital
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Alison De Souza
Mercy Hospital for Women
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Alex Wong
Box Hill Hospital
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James Keck
St Vincent Hospital
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Lore Schierlitz
Mercy Hospital for Women
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Abstract

Objective We report our experience with a transvaginal approach with overlapping AS repair. The aim of this study was to evaluate long term functional outcomes. Design Retrospective Cohort study. Setting and Population Women who had undergone AS surgery for anal incontinence from July 2005 to July 2020. were included. The patients included attended the Mercy Hospital Perineal clinic a multidisciplinary team of urogynecologists and colorectal surgeons. Private patients from the surgeons in Perineal clinic were also included. Methods Overall 107 women were included in the study with a median follow up of 57.5 months. Main Outcome Measure We analysed outcomes by comparing patients St marks score difference before and after surgery. Meaningful clinical difference (MID) was set at 5 points as per previous validation studies, complications and patient demographics were recorded along with a question if they would recommend this treatment to a friend. Results An improvement exceeding the minimal clinical difference (MID) was seen in 69.3% of women. With a marked improvement in 46.5% of patients. Furthermore 70% of our patients would recommend the procedure to a friend, if they were in a similar situation. Wound infection or perineal breakdown occurred in 45% of women but did not significantly impact on outcomes. Conclusion Transvaginal AS repair is associated with significant improvements in patients’ St. Marks score. Our data shows that the long-term success rate of transvaginal AS repair may be better than previously reported in the literature using a transvaginal approach. Funding This study received no funding or sponsorship
02 Oct 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
12 Oct 2021Submission Checks Completed
12 Oct 2021Assigned to Editor
18 Oct 2021Reviewer(s) Assigned
31 Oct 2021Review(s) Completed, Editorial Evaluation Pending