Pressure and sensation in the anal canal after minor anorectal procedures

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Abstract
Thirteen patients previously treated surgically for fistula-in-ano and 10 previously treated by hemorrhoidec-tomy have been investigated to detect the alterations in anal function after operation. Sphincter activity has been estimated by recording intraluminal pressures with fine, openended, water-filled polythene tubes connected to pressure recording apparatus. The degree of sensory response of the anal canal to light touch was measured. Sphincter responses to balloon distention of the rectum were also recorded. After fistula operations diminished, pressure in the caudal 2 cm. of the anal canal was accompanied by incomplete relaxation in response to balloon distention of the rectum. Large, insensitive scars were also found in the anal canal. These factors, in combination, may explain the minor defects of anal control. After hemorrhoidectomy, only minor changes in pressure and sensation were observed in the anal canal which explains the low incidence of functional deficiency in such patients, but does not explain individual lack of control.