J.Jpn. Surg. Soc.. 88(9): 1296-1299, 1987

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Report on the annual meeting

THE FUNCTION OF THE ANORECTAL SPHINCTER AFTER ABDOMINO-PERINEAL ANOPLASTY FOR THE SUPRALEVATOR-TYPE DISORDER ASSOCIATED WITH AN IMPERFORATE ANUS

To clarify the causes of constipation in 13 patients and incontinence in 4 patients following 29 abdomino-perineal anoplasty (Nichidai Methode) for the supra levator-type disorder associated with an imperforate anus, the percentage of maximum static anorectal pressure and reflex profile were determined by anorectal manometry in 107 normal controls and 27 patients. Terminal morter latency in the pudental nerves was measured in ten normal controls and 17 patients.
Supralevator-type disorders consisted of the fixed type recto-vesical fistula, in which the terminal rectum remained high near the pubococcygeal line (P-C line), and the second type recto-urethral fistula in which the terminal rectum remained below the level of the P-C line. Patients with the fixed type associated with constipation had low anorectal pressure (30％), no reactive reflex profile and no or delayed of terminal morter latency. These findings were similar to those in patients with incontinence. These symptoms were thought to be originated from congenital disorders of the anorectal sphincter and nervous system. In patients with the second type associated with constipation, the anorectal pressure (50％) and reflex profile were normal, but they had delayed terminal motor latency. These symptoms were thought to be derived from secondary disorder of the nervous system.

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