Re-routing procedures for ectopic anus in the adult

Four cases of adult ectopic anus are described. All patients presented with incontinence; in two there was a history of constipation. Electromyography correctly identified the site of the anal sphincters pre-operatively. The anorectum was mobilized and re-routed through the sphincter ring with repair of the perineal body. There was improvement in anal canal pressures on voluntary contraction after operation in all three cases studied. Continence was restored in three patients but results were poor in one patient because of persistent constipation. Severe constipation may be a contra-indication to this procedure.