V-Y advancement flap This procedure is an alternative to Y-V anoplasty. Aitola et al[ 25 ]. These extensive procedures may require bowel confinement for 3 d to 5 d after which a high-fiber diet is initiated. Other times the atresia or stenosis is higher in the pelvis; if high, nerves may be malformed and muscle structures can be affected. Because of the wide base, it avoids the pitfall of having a narrow apex present inside the anal canal that may become ischemic. The internal sphincter is what we call an involuntary muscle. The external part of the wound is left open to minimize ectropion formation.
There are many variations of this procedure, and one is selected depending on the size and structure of the stenosis.
Anal Stenosis or Stricture: Causes, Symptoms, Diagnosis, and Treatment
In Milligan-Morgan hemorrhoidectomy, internal sphincterotomy, if necessary, associated with preservation of adequate muco-cutaneous bridges, prevents anal stenosis. Similar to the Y-V flap, these flaps can be done in any location and can be done bilaterally if needed. Proximal part of the flap is very narrow and will not allow for a significant widening of the stricture above the dentate line. The stenosis rate following stapled mucosectomy generally ranges from 0. This gradual and natural dilation is very effective in most patients. After the use of stool softeners in the pre-operative period, enema is performed on the day of surgery.