An anoplasty is an anorectal procedure that involves reconstructing or fixing issues that keep the anus from functioning properly. Certain defects manifest at birth, while others result from injury or illness.
The anus serves as the terminal point of the large intestine, comprising a relatively short tube, approximately 3 to 4 centimeters in length. It is encircled by sphincter muscles, which facilitate the expulsion of fecal matter from the body.
Anoplasty may be necessary if surgery or a medical condition has led to the narrowing of the anal canal due to scar tissue. For a child, this procedure might be required if they are born with an abnormal anus.
Anoplasty may be recommended due to the certain health conditions, such as:
There are several risks associated with anoplasty. Potential long–term complications include stenosis, which may arise if regular dilation of the anus is not performed during the healing process.
There is also a rare but possible risk of developing fistulas due to an internal infection post–surgery, causing a hole in the anus. In such cases, a subsequent surgical procedure is typically required to close the fistula. Other long–term complications include:
Anoplasty also comes with short–term complication, such as:
Prior to the procedure, a bowel preparation kit is provided to facilitate emptying of bowels in preparation for the treatment. This kit usually consists of an oral laxative formula that one will take the day before the procedure, effectively emptying their bowels.
A specific diet may be prescribed for several days, typically starting with a low–fiber diet for two days and then transitioning to only clear liquids on the final day before taking the formula.
Anoplasty typically begins with administering general anesthesia. The procedure involves utilizing an electric stimulator machine. This device helps induce contractions in the anal muscles, assisting healthcare providers in precisely locating the two sphincter muscles that define the two ends of the anus or its intended position.
Anoplasty aims to restore or establish a functional anal canal, and the approach to the procedure is usually tailored to one’s condition.
However, this procedure results in a gap in the inner lining. To address this, skin flap from the perianal region, which is located inside the buttocks just outside of the anus, will be removed. Leaving it attached on one side, the flap will be used to cover the gap and the perianal wound will be closed with stitches.
One might also leave the hospital the same day or stay there for a few days, depending on how complex the procedure was. Follow–up visits will be scheduled frequently in the weeks following the procedure to monitor the healing process.
As part of the recovery, performing regular anal dilations may be required. This involves inserting a specialized dilator into the anus daily to facilitate stretching. The purpose of this dilation is to train the tissues, ensuring that the new anus settles at the correct diameter and helps prevent narrowing and scarring during the healing phase.
Constipation might be experienced, and a specific diet to follow may be recommended during the recovery phase. Pain management medication may be prescribed as an anorectal procedures typically involve low pain threshold.
The recovery period, which involves daily dilations, typically spans four to eight weeks. It is normal for the anus to experience minor bleeding during these daily dilations, which is generally not very painful. After the complete healing of the anus, infants with colostomies will be prepared for their final surgery to reverse the colostomy.
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