This repair first devised by Sir Alan Parks, is deigned to strengthen and make more ‘snug’ the pelvic floor around the anus as it passes through the pelvic floor. The pelvic floor is accessed behind (posterior to) the anus, hence its name (postanal repair).
Initial results from multiple studies showed promise with this procedure resulting in significant improvement in short-term continence. However, a large Birmingham study looking at long term continence rates showed only one third remained continent at long-term follow up .
The main role of postanal repair is therefore in conjunction with another procedure, or where sacral nerve stimulation has failed or is not an option.
Yoshiola K, Keighley MRB. Critical assessment of quality of continence after postanal repair for faecal incontinence. Br J Surg. 1989; 76:1054-7.