Functional Activity of the Internal Anal Sphincter Following Haemorroidectomy. A Long-term Manometric Study

Abstract

Background: Haemorrhoidal disease is the most prevalent disorder of the anorectal region. It affects 4.4% of the western population and most of these patients are symptomatic and need treatment. The aim of this study was to evaluate long term results of the sphincter function following haemorrhoidectomy.Method: Between the years 2004-2007, 48 patients (28 females and 20 males) who underwent haemorrhoidectomy were included in the study. All patients had third or fourth degree symptomatic hemorrhoids and had three column Milligan-Morgan operation. Manometric studies were performed before surgery and repeated post-operatively at one, three, six and 12 months. A control group included 12 normal volunteers 5 women and 7 men. All the patients had a manometric evaluation using a 6 channel perfusion catheter.Results: Baseline manometric measurement in the hemorrhoids group was significantly higher than in the control group (108.4±23 mmHg vs. 73±5.9 mmHg, p<0.0001). Following surgery the pressure declined after 1 month to a level of 74.5±12.8 mmHg and rose gradually to 103.6±21.5 mmHg after 12 months. These levels were still significantly higher than those of the control group. ARTICOL ORIGINAL ORIGINAL ARTICLE Conclusion:The function of the internal anal sphincter is only temporarily disturbed but regains its strength gradually over one year. Longer anal retraction results in a greater decline in manometric values after 12 months.