A surgical technique for secondary repair of obstetric anal sphincter injuries; sphinctero-vagino-perineoplasty/Obstetrik anal sfinkter hasarinin sekonder onariminda cerrahi teknik; sfinktero-vajino-perineoplasti

Objective: This study was conducted to present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of obstetric anal sphincter injuries. Materials and Methods: This retrospective study was conducted on the records of seven patients who underwent secondary repair of obstetric anal sphincter injuries at the colorectal surgery unit of a tertiary care center between February 2015 and December 2017. Results: All patients with solid stool incontinence were fully recovered at postoperative month 3. The Wexner incontinence score was significantly improved (decreased from 14.12 [range: 8-20] to 2.28 [range: 1-4]). The complication rate was 85.7% (wound infection, abscess, hematoma, detachment). Conclusion: Combined repair of anal sphinchters, perineal body, superfcial transverse perineal muscles, and bulbospongious muscles, which contribute to anal continence, may improve surgical outcomes in patients with obstetric anal sphincter injuries. Keywords: Anal incontinence, obstetric anal sphincter injury, perineoplasty, sphincteroplasty, vaginoplasty Oz Amac: Bu calisma obstetrik anal sfkter hasarinin sekonder onariminda sfnktero-vajino-perineoplasti uygulanan yedi hastanin erken donem sonuclarini bildirmek amaciyla yapildi. Gerec ve Yontemler: Obstetrik anal sfkter hasari nedeniyle sekonder onarim planlanan ve Subat 2015-Aralik 2017 tarihleri arasinda bir universite hastanesinin kolorektal cerrahi unitesinde sfnktero-vajino-perineoplasti uygulanan yedi hastanin kayitlari geriye donuk incelendi. Bulgular: Postoperatif 3. ayda hicbir hastada kati gaita inkontinansi gozlenmedi. Wexner inkontinans skorunda belirgin duzelme (14,12'den [aralik: 8-20] 2,28'e [aralik: 1-4] geriledi) izlendi. Hastalarin %85,7'sinde komplikasyon (infeksiyon, abse, hematom, detasman) gelisti. Sonuc: Anal kontinansi olusturan yapilarin (anal sfnkterler, perineal body, superfsyal transvers perineal kaslar, bulbospongiosus kaslar) kombine onarimi obstetrik anal sfnkter hasarinin sekonder onariminda daha iyi sonuclar edilmesine imkan saglayabilir. Anahtar Kelimeler: Anal inkontinans, obstetrik anal sfnkter hasari, perineoplasti, sfnkteroplasti, vajinoplasti PRECIS: We present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of OASIS.