To optimize outcomes, be sure to address patient expectations, and remind them that the return to normal muscle and sphincter function is slow, and can take up to 3 months. Kegel exercises can help strengthen the muscles during recovery, she said. Infection rates are low—less than 8%-in overlapping sphincteroplasty patients, but the presence of infection increases the failure rate.
The most significant factor in a successful sphincter repair is its durability, and constipation must be prevented to preserve the intactness of the repair in the immediate postoperative period.
“Constipation is the enemy of a sphincter repair in the first week or two,” Dr. Mahmoud said. She uses a combination of treatments including milk of magnesia, fiber, and stool softeners, and mineral oil, to help steer patients through recovery.