Anal continence following surgery for imperforate anus

Measurements of force in the anal canal, electrical activity of the smooth muscle of the internal sphincter, and the response to rectal distension, as well as subjective assessment of continence, have been made on a series of children operated upon for imperforate anus between 1955 and 1965. The most useful objective measurement appeared to be the reflex response in the anal canal on rectal distension. When a normal response occurred, good or moderate continence was observed. Poor continence was associated with a rise in anal canal force. The force in the anal canal on voluntary squeezing proved to be less informative in assessing continence than did the presence of a palpable puborectalis.