levator ani muscle fold

The levator ani muscle folding surgery is a surgical treatment for levatorsyndrome. The disease was confirmed as an independent disease as early as 1841. The clinical name is not uniform. Some scholars call it levator ani muscle. Syndrome, paroxysmal anal pain, levator ani muscle spasm, anal tail bone pain. Treatment of diseases: anal canal sphincter spasm contraction levator ani muscle syndrome Indication Decreased levator ani muscle function due to childbirth, pelvic surgery, anal surgery, enteritis syndrome, excessive sexual intercourse. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation 1. Intestinal preparation: Advance 3 days of fluid diet, and oral intestinal antibiotics. Clean the enema before and on the morning of the operation. 2. Vulvar and vaginal preparation: 3 days before surgery, with 1:5000 potassium permanganate basin, disinfection cotton ball to wipe the vulva and vagina Surgical procedure 1. Position and disinfection: take the stone. Routine disinfection of the vulva and vagina. 2. Incision: A similar incision is made along the lateral edge of the pupillary scar. For the large pupil, an incision from the lower edge of the pupil to the center of the anus is required. 3. Cut the anus: cut along the midline, from the anal sphincter and perineum, up to the edge of the pupil. 4. Separate the vaginal and rectal wall: When the fistula has obvious scar, remove it first, but not too much, so as to avoid vaginal and rectal stenosis after repair. The mucosa of the vagina and rectum is separated sharply and/or bluntly along the pupil. 5. Stitching the rectal wall: 1 cm from the edge of the rectal mucosa, two layers of varus, discontinuity, suture the rectal wall. 6. Stitching the anal sphincter: The anal sphincter fracture ends of the rectum on both sides of the rectum, and the suture is pulled toward the midline, and the "8" suture is performed. 7. suture the rectal fascia: intermittent suture of the rectal fascia. 8. Check the anal sphincter and rectum: Insert the finger into the anus. When the patient contractes the anus, there may be a sense of contraction, suggesting that the anal sphincter has been sutured intact, and the rectal suture can also be examined. 9. Stitching the levator ani muscle: the anterior levator ani muscle is sutured with 2 to 3 needles. 10. Stitching the vaginal wall: the vaginal wall is sutured intermittently, and the cervix marks are opposite. 11. Suture the perineal skin. 12. Check the rectum and vagina: the vagina should be able to accommodate two fingers, the anus is slightly loose by a finger, and has a sphincter contraction. Too tight anus can cause difficulty in defecation and should be noted during surgery. 13. After the operation, the vagina was filled with iodoform gauze and taken out in 72 hours.