Levatorplasty: A secondary operation for fecal incontinence following primary operation for anorectal agenesis.

A procedure is described which combines the posterior liberation of the levator with the levator plication. This operation was performed in 15 children, born with anorectal agenesis, all of whom were incontinent of feces after primary operation. Four of the 15 children became fully continent following levatorplasty, seven patients now have only occasional soiling, and four patients continue to soil persistently. In all the cases, a good correlation was found between bowel control after levatorplasty and anal canal pressures. Normal resting anal canal pressure was as significant as the voluntary squeeze pressure in relation to continence.