Frequency of Postoperative Fecal Incontinence in Patients Undergoing Open Anal Internal Sphincterotomy for Chronic Anal Fissure

Background: Chronic anal fissure is a common proctologic condition characterized by pain and bleeding during defecation. Open anal internal sphincterotomy is considered the gold standard surgical treatment, though postoperative fecal incontinence remains a concerning complication that can affect quality of life. Objective: To determine the frequency of postoperative fecal incontinence in patients undergoing open anal internal sphincterotomy for chronic anal fissure. Study Design: Descriptive study. Setting: The Department of General Surgery at Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: 01-12-2024 to 01-05-2025. Methods: A total of 101 patients with chronic anal fissure were enrolled. Chronic fissure was defined as painful defecation with bleeding per rectum persisting for more than six weeks, with clinical findings of an anal mucosal tear or sentinel pile. All patients underwent open anal internal sphincterotomy under general anesthesia. Postoperative fecal incontinence was defined as uncontrolled passage of feces for ≥15 days after surgery. Data were analyzed using descriptive statistics. Results: The mean age of participants was 40.54 ± 14.85 years. There were 63 males (62.4%) and 38 females (37.6%). Postoperative fecal incontinence occurred in 15 patients, representing a frequency of 14.9%. Conclusion: Open anal internal sphincterotomy is an effective treatment for chronic anal fissure; however, postoperative fecal incontinence occurred in 14.9% of cases. Careful patient selection, preoperative counseling, and long-term follow-up are recommended to minimize and monitor this complication.