Sphincterolevatoroplasty for post-traumatic anal incontinence in women
Glukhov E.Yu., Glukhova V.E., Kuznetsov V.V., Kurkova T.F., Larionov V.A., Neff E.I., Taskaev I.A., Khizadze A.G., Dikke G.B.
Background. Anal incontinence (AI) in women following traumatic childbirth occurs in 8.6 to 59% of cases, depending on the degree of damage to the anal sphincter. Simultaneous surgeries combining sphincteroplasty, levatorplasty, sphincter-levatorplasty (SLP), and perineal reconstruction are pathogenetically justified treatment options.
Objective. To evaluate the effectiveness of SLP in treating AI in women with posttraumatic external anal sphincter insufficiency.
Materials and methods. An uncontrolled, quasi-experimental clinical study was conducted to evaluate the surgical outcomes of 43 patients who underwent surgery between 2019 and 2025. An analysis was performed of clinical and anamnestic data, morphological changes in the external anal sphincter, concomitant pelvic organ prolapse, and immediate and long-term results of SLP. Functional outcomes were assessed based on changes in anal incontinence symptoms, urinary incontinence, and patient satisfaction.
Results. The mean patient age was 43.8 (10.6) years (range, 26–68 years). The postpartum interval ranged from 1 to 15 years (mean interval, 5.5 years). All patients had anal incontinence symptoms before surgery. The effectiveness of SLP was 79.1%, with complete relief of anal incontinence symptoms in all patients. There was a statistically significant reduction in urinary incontinence and sexual dysfunction (p < 0.01). The patient satisfaction rate with the treatment results was 90.7%.
Conclusion. Anal incontinence in women after vaginal delivery is a consequence of combined damage to the external anal sphincter, perineal body, and levator apparatus. A comprehensive approach to the diagnosis and treatment of women with post-traumatic defects of the sphincter complex and AI, including sphincterolevatoroplasty, led to clinical recovery in 79.1% of patients and treatment satisfaction in 90.7%.
Authors' contributions. Glukhov E.Yu. – organization and supervision of the study, performance of surgical procedures; Kuznetsov V.V., Neff E.I., Taskaev I.A. – drafting and formatting of the manuscript, performance of surgical procedures; Glukhova V.E., Kurkova T.F., Larionov V.A., Khizadze A.G. – analysis of literature data, review of publications on the topic, drafting the first version of the manuscript; Dikke G.B. – editing the manuscript, preparing the manuscript for publication. All authors guarantee the accuracy of all parts of the study and have approved the final version of the manuscript.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.
Ethical Approval. The study was reviewed and approved by the Research Ethics Committee of the Ural State Medical University.
Generative Artificial Intelligence. No artificial intelligence tools were used in the preparation of this manuscript.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Glukhov E.Yu., Glukhova V.E., Kuznetsov V.V., Kurkova T.F., Larionov V.A., Neff E.I., Taskaev I.A., Khizadze A.G., Dikke G.B. Sphincterolevatoroplasty for post-traumatic anal incontinence in women.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (8): 119-128 (in Russian)
https://dx.doi.org/10.18565/aig.2026.169
Keywords
anal incontinence
anal sphincter rupture
sphincteroplasty
sphincterolevatoroplasty
levatorplasty
pelvic floor
reconstructive surgery
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Received 22.05.2026
Accepted 15.07.2026
About the Authors
Evgeny Yu. Glukhov, Dr. Med. Sci., Chief Physician, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19; Professor at the Department of Obstetrics and Gynecology with a Course in Medical Genetics, Ural State Medical University, Ministry of Health of Russia, 620028, Russia, Yekaterinburg, Repina str., 3, 9222241411@mail.ru, https://orcid.org/0000-0003-3899-8382Victoria E. Glukhova, obstetrician-gynecologist, Head of the Ultrasound Diagnostics Department, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg,
Botanicheskaya str., 19, gluhovav17@mail.ru, https://orcid.org/0009-0006-1656-5411
Viktor V. Kuznetsov, obstetrician-gynecologist, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19; 79220317537@yandex.ru,
https://orcid.org/0009-0006-5608-7274
Tatiana F. Kurkova, obstetrician-gynecologist, ultrasound physician, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19, kurkovagyn@ya.ru, https://orcid.org/0009-0009-6360-9044
Vladislav A. Larionov, obstetrician-gynecologist, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19, vlad23421@gmail.com,
https://orcid.org/0009-0002-9853-6403
Ekaterina I. Neff, PhD, Deputy Chief Physician for Medical Affairs, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19; Assistant at the Department of Obstetrics and Gynecology with a Course in Medical Genetics, Ural State Medical University, Ministry of Health of Russia, 620028, Russia, Yekaterinburg, Repina str., 3, neff1974@mail.ru, https://orcid.org/0009-0000-5312-1007
Igor A. Taskaev, proctologist, Head of the Proctology Department, City Clinical Hospital No. 40, 620102, Russia, Yekaterinburg, Volgogradskaya str., 191,
Taskaev82@bk.ru, https://orcid.org/0009-0002-3803-9173 Artem G. Khizadze, obstetrician-gynecologist, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19, khizadze.artem@gmail.com, https://orcid.org/0009-0006-9542-5184
Galina B. Dikke, Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology with a Course of Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, 190013, Russia, St. Petersburg, Moskovskiy Ave., 22 Liter M, galadikke@yandex.ru, https://orcid.org/0000-0001-9524-8962
Corresponding author: Evgeny Yu. Glukhov, 9222241411@mail.ru
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