The internal anal sphincter , IAS , or sphincter ani internus is a ring of smooth muscle that surrounds about 2. Its action is entirely involuntary , and it is in a state of continuous maximal contraction. It helps the Sphincter ani externus to occlude the anal aperture and aids in the expulsion of the feces. Sympathetic fibers from the superior rectal and hypogastric plexuses stimulate and maintain internal anal sphincter contraction.
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Anal sphincter injuries are uncommon injuries outside of obstetric practice — but they may cause disastrous complications. We present a case of complete anal sphincter disruption from anal intercourse in a 25 year old woman. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after days of follow up. This is one of a handful of reported cases of anal sphincter disruption secondary to anal intercourse. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice.
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An anal sphincter is a group of muscles at the end of the rectum that surrounds the anus and controls the release of stool, thereby maintaining continence. There are two sphincter muscles: one is internal and one is external. The external muscle helps maintain continence and keep stool in the rectum.
The rectum is a muscular tube about 13 cm 5 in. The rectum connects the colon to the anus, which is the opening where stool exits the body. The internal and external anal sphincters are rings of muscle at the opening of the anus.