Abstract

ABSTRACT: Difficulty in rectal emptying, incontinence, solitary ulcer with bleeding, physical finding of lax puborectalis musculature, obtuseness of the anorectal angle, and bulging of the anterior rectal wall into the proctoscope suggest incontinence amenable to puborectalis plication. Puborectalis plication sphincteroplasty is useful in correcting patulousness and incontinence attendant with rectal procidentia, as well as certain cases of lax or nonresponsive puborectalis muscle related to indiopathic collagen disorders. Anorectal burning after correction of patulousness is related to irritable bowel aggravation, as occurred in one of my nine patients. Despite the short follow-up, preliminary results seem to warrant puborectalis sphincteroplasty in selected patients.