Esfinteroplastia con superposición de cabos en una lesión obstétrica

Obstetric anal sphincter injury is a common cause of fecal incontinence in women of reproductive age. Maternal and fetal risk factors can increase the incidence. The injuries are classified into four grades according to Sultan, and their repair can be immediate or delayed. This case presents a 27-year-old woman with fecal incontinence due to a grade 4 anal sphincter injury. An overlapping sphincteroplasty was performed, where the internal and external anal sphincter muscle bundles were dissected and identified, preserving part of the fibrous tissue for the reconstruction. The patient showed favorable progress, significantly improving her incontinence. The overlapping technique has evolved over time, presenting various modifications and approaches. Methods such as separate dissection of the sphincters and performing repairs without preserving fibrosis have been introduced. In the presented case, separate dissection and preservation of fibrous tissue resulted in good functional outcomes. In conclusion, overlapping sphincteroplasty remains a current and effective technique for the repair of anal sphincter injuries, offering a viable surgical alternative with good functional results.