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What Is Sphincteroplasty?

Sphincteroplasty is surgery that repairs a damaged anal sphincter to improve control of bowel movements. It is most commonly used when a defined defect in the external anal sphincter contributes to fecal incontinence, often after obstetric injury or prior anorectal surgery. The damaged muscle ends are identified and sutured back together, commonly with an overlapping repair. The operation restores the physical continuity of the sphincter but cannot fully correct nerve damage or other causes of incontinence.

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What Is Sphincteroplasty?

Sphincteroplasty is surgery that repairs a damaged anal sphincter to improve control of bowel movements. It is most commonly used when a defined defect in the external anal sphincter contributes to fecal incontinence, often after obstetric injury or prior anorectal surgery. The damaged muscle ends are identified and sutured back together, commonly with an overlapping repair. The operation restores the physical continuity of the sphincter but cannot fully correct nerve damage or other causes of incontinence.

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Why Is Sphincteroplasty Performed?

The procedure is considered for selected patients with fecal incontinence caused by a structural anal sphincter defect. Endoanal ultrasound, examination, symptom history, and sometimes anorectal physiology testing help confirm that a repairable defect is present. Nonsurgical treatments such as dietary changes, medications, pelvic-floor therapy, and bowel-management strategies are generally tried first when appropriate. Long-term continence can decline after sphincteroplasty, so the decision also considers age, nerve function, defect characteristics, prior repairs, and alternative treatments.

How Is Sphincteroplasty Performed?

The surgeon makes an incision near the anus or perineum and carefully identifies the separated ends of the damaged sphincter muscle. Scar tissue is mobilized enough to bring healthy muscle edges together without excessive tension. In an overlapping sphincteroplasty, one end of the external sphincter is placed over the other and secured with sutures to reconstruct a stronger muscular ring. Associated perineal defects can also be repaired during the same operation when needed.

What Is Recovery Like After Sphincteroplasty?

Recovery focuses on wound healing, pain control, stool consistency, and protection of the repaired muscle during the early postoperative period. Patients are commonly advised to avoid straining and to use a bowel regimen that keeps stools soft but formed. Pelvic-floor rehabilitation can be introduced after the repair has healed sufficiently. Continence improvement can occur over the following months, although long-term results vary and symptoms can gradually return.

What Are the Risks and Complications?

Possible complications include infection, wound separation, bleeding, pain, scar formation, and temporary difficulty with bowel movements. The repair can break down or stretch, leading to recurrent fecal incontinence. Some patients continue to have symptoms because nerve injury, internal sphincter damage, rectal dysfunction, or other pelvic-floor problems remain. Further treatment can include pelvic-floor therapy, sacral neuromodulation, repeat repair, or another continence procedure.

Frequently Asked Questions About Sphincteroplasty

What type of incontinence does sphincteroplasty treat?

It is mainly used for fecal incontinence associated with a defined structural defect in the anal sphincter, particularly the external sphincter.

What is an overlapping sphincteroplasty?

It is a repair in which the mobilized ends of the torn external anal sphincter are overlapped and sutured together rather than joined edge to edge.

Does sphincteroplasty permanently cure fecal incontinence?

Not always. Many patients improve after surgery, but continence can worsen again over time, especially when nerve damage or other pelvic-floor problems are also present.

Can other treatments be used after sphincteroplasty?

Yes. Persistent or recurrent symptoms can be treated with bowel-management strategies, pelvic-floor therapy, sacral neuromodulation, or selected additional procedures.

References

Overlapping Sphincteroplasty: Is It the Standard of Care? PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC2780126/. Date Accessed August 13, 2026.

Sphincteroplasty for fecal incontinence in the era of sacral nerve modulation. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC2980674/. Date Accessed August 13, 2026.

Short- and long-term outcomes of sphincteroplasty for anal incontinence: a systematic review. PubMed. https://pubmed.ncbi.nlm.nih.gov/37516713/. Date Accessed August 13, 2026.

Long-term outcomes of anal sphincter repair for fecal incontinence: a systematic review. PubMed. https://pubmed.ncbi.nlm.nih.gov/22426274/. Date Accessed August 13, 2026.

Japanese Practice Guidelines for Fecal Incontinence Part 3 -Surgical Treatment for Fecal Incontinence, Fecal Incontinence in a Special Conditions- English Version. PubMed. https://pubmed.ncbi.nlm.nih.gov/33537503/. Date Accessed August 13, 2026.