Bilateral gluteus maximus transposition for anal XXXX .

@entity1 @entity1146 @entity322 @entity2737
Seven @entity1 (five @entity1 and two @entity1 ) with anal @entity322 in whom previous surgery had failed, were treated by bilateral gluteus maximus transposition. All @entity1 were incontinent to solid stool. Previous surgery was postanal repair in four @entity1 and secondary overlapping suture for obstetric tear in one. The two @entity1 were treated in childhood for anal @entity1146 . No covering stoma was used. @entity2737 occurred in three @entity1 , requiring surgical drainage in two. After follow-up of more than 1 year three @entity1 experienced improved continence but in four continence was unchanged. Anorectal physiology studies showed moderately increased resting and squeeze pressures in @entity1 who were improved by the operation, but none could retain more than 200 ml of viscous fluid instilled into the rectum. No change in rectal sensitivity or volume tolerance was found. This preliminary series does not indicate that better results are obtained by gluteus maximus transposition than by unstimulated graciloplasty.
