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March 1, 1929


Author Affiliations

From the Department of Surgery, Johns Hopkins University School of Medicine.

Arch Surg. 1929;18(3):845-851. doi:10.1001/archsurg.1929.04420040077008

Loss of control of the anal sphincter may result from distant lesions, chiefly involving the central nervous system and resulting in paralysis, or from local injuries to the muscle itself or to the nerves entering it. Of the second group of cases perhaps a majority are due to surgical operations, often undertaken with clear knowledge that incontinence may result, but nevertheless necessary. The condition is most distressing. It is frequently associated with a greater or less degree of prolapse of the rectal mucosa. Incontinence may be partial or complete. Often with a high degree of incontinence and marked prolapse the patient not only is unfitted for any form of social life, but is so uncomfortable physically as to be actually bedridden.

A number of methods have been described for the treatment of anal incontinence. I have tried most of them, from simple suture of the remnants of the damaged muscle

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