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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

Anoplasty (Anal Reconstruction)

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Back to work
2-4 weeks
Success rate
85-95%
Recurrence
5-15%

What it is

What is Anoplasty?

Anoplasty, or anal reconstruction, is a surgical procedure to repair, reconstruct, or create an anal opening. It is most commonly performed to correct anal stenosis (a narrowing of the anal canal), but is also used to repair chronic anal fissures, treat certain types of anal fistulas, or reconstruct the anus after trauma or cancer surgery. The procedure involves excising scar tissue and advancing a flap of healthy, pliable skin and subcutaneous tissue into the anal canal to widen the opening, improve its function, and bring a robust blood supply to promote healing. Several types of flaps can be used, such as V-Y, diamond, or house flaps, depending on the extent and location of the reconstruction needed.

Am I a candidate?

Who is a Good Candidate for Anoplasty?

Ideal candidates are patients with symptomatic anorectal conditions that have not responded to conservative management. This includes:

  • Anal Stenosis: Patients with moderate to severe symptomatic anal stenosis causing difficult or painful bowel movements.
  • Chronic Anal Fissure: Patients with chronic fissures that have failed medical and surgical therapies (like sphincterotomy), or those with low sphincter pressures where a sphincterotomy is not advised.
  • Complex Anal Fistula: Select patients may require an anoplasty as part of a complex fistula repair.
  • Anal Reconstruction: Patients who require reconstruction of the anal canal after trauma or surgical excision for cancer.

Recovery

What is the Recovery Like?

Recovery after anoplasty typically takes several weeks. Patients will experience moderate anal pain and some drainage from the incisions for the first 1-2 weeks. Pain is managed with oral pain medications and frequent warm sitz baths. Maintaining soft, bulky stools with a high-fiber diet and plenty of fluids is crucial to prevent straining, which could compromise the flap repair. Patients are typically advised to avoid strenuous activity for 2 to 4 weeks. Complete healing of the flaps can take 6 to 8 weeks.

Risks & considerations

What are the Risks?

While anoplasty is a safe and effective procedure, it has potential risks, including:

  • Pain: Postoperative pain is expected but is typically well-managed with oral pain medication, sitz baths, and stool softeners.
  • Bleeding: Minor bleeding or spotting from the suture lines is common. Significant bleeding is rare.
  • Infection or Flap Dehiscence: A wound infection can occur, which may lead to partial or complete breakdown (dehiscence) of the flap repair.
  • Fecal Incontinence: There is a small risk of new or worsened incontinence to flatus or stool, particularly if a sphincterotomy is performed in conjunction with the anoplasty.
  • Restenosis: The stricture or narrowing can recur if the scar tissue reforms, which may require repeat dilation or another surgical procedure.

Sources

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