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Anal Sphincter Repair

The indications for repairing an anal sphincter are usually disruption following injury. The latter almost e'er relates to a traumatic vaginal delivery. On most occasions this is recognised at the fourth dimension of the delivery and an immediate repair is undertaken by the attending obstetrician. However a secondary repair may be required if it is deemed that the chief repair has been suboptimal.

Pre-operative Grooming for a Anal Sphincter Repair procedure

Y'all volition be restricted to fluids simply for the whole twenty-four hour period prior to your process upward to midnight. From midnight through to 2 hours prior to the procedure you can drinkable water merely and from and then on, until after the procedure you must be nada by mouth. Yous are too required to administer a Fleet enema at to the lowest degree 2 hours prior to your operation. You lot will receive specific instructions about this well in advance of the procedure, including an access fourth dimension and an judge time for the procedure itself. You should take your normal medications as usual with a sip of h2o unless specifically directed otherwise. All anti-coagulant therapy should have been ceased in accordance with instructions issued by Dr Renaut's office.

Procedure

The operation is performed under general anaesthesia. The patient is normally required to stay in hospital for three to four days or at least until the bowels are working satisfactorily. Almost sphincter injuries are anterior, ie the segment of sphincter directly backside the vagina. The objective is to practise an overlapping repair of the externals (voluntary) sphincter. A horseshoe incision is made effectually the anus. The ends of the separated external sphincter are located and brought to the midline. An overlapping repair is then fashioned. The wound is closed with usually absorbable sutures that go under the skin (and therefore exercise not need to be removed). A small plastic drain may be inserted that allows the drainage of excess fluid that might collect in the firsthand post-operative menstruum. This is usually taken out on the ward before discharge.

Postal service-operative Care following a Anal Sphincter Repair procedure

Following your procedure there are a number of things of which you lot demand to be enlightened.

Discomfort

Information technology is inevitable that you will experience some discomfort following your surgery in the region of where the anal sphincter repair has been performed. As it is a relatively pocket-sized incision this discomfort should be no greater than the pain you were experiencing. Long interim local anaesthetic will have been injected into the wounds but later on a few hours this issue will article of clothing off. Before it does and then information technology is important to have some pain killers on board and to continue these on a regular basis. You will be sent home with some pain killers - my preference is either Panadeine Forte or Nurofen. I recommend that you have these initially on a regular basis as directed on the package. Later on about 48hrs it should be necessary to take these only as required.

Bowel activity

The bowels will probably non work for a couple of days later on the surgery. Medication in the class of Coloxyl will be prescribed to keep the stool soft and this should be continued at home for several days. It is besides advisable to add in a fibre supplement such as Metamucil or Normocol. A normal diet tin can be resumed straight away.

Bleeding

A small amount of haemorrhage in the showtime two or three days is not unexpected, specially with defaecation. If information technology appears excessive so merely use some pressure with a gauze pad for 15-20mins.

Swelling

Yous may experience swelling in the perianal region lasting for a few days just this volition subside of its own accord in due grade.

Wound Care

The healing of the anal sphincter repair wound can be aided by simply cleaning the wound with soap and water in the shower, particularly once once again later defaecation. Bathing the area in a warm table salt bathroom may help your level of discomfort simply probably won't alter the fashion the area heals. Infection is unusual and if it does occur will usually settle of its ain accord without the need for antibiotics. Whatever sutures will dissolve past themselves. If you think they have fallen out prematurely and the wound is gaping exercise not be alarmed - it will close past itself without the need for resuturing.

Concrete Activity (including sex activity)

Resuming physical activity is largely one of common sense. Certainly moving effectually the house and going for brusk walks in the commencement couple of days is desirable. Anything more than this volition be destined to cause more discomfort. An increment in the level of activity should be guided by the level of discomfort. You should be able to resume your normal 24-hour interval to twenty-four hours activities within a few days, so long as this does not include marked exertion. You should all the same be able to return to the gym or similar activities inside a couple of weeks.

Follow up

Dr Renaut will see you for a review in his office approximately four to six weeks after the surgery. He routinely notifies your GP of all procedures and your progress.

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