Older Adults with Anal Incontinence Operated on using the Thiersch Technique

Abstract

Introduction: The Thiersch operation is particularly recommended for older adults with anal incontinence and a certain degree of rectal prolapse, as although it does not completely restore continence, it does reduce mucus secretion and mucosal prolapse.

Objective: To present the experience of the Thiersch operation in older adults with anal incontinence operated on in the coloproctology department of the Comandante Manuel Fajardo University Surgical Hospital.

Methods: A descriptive and observational study was conducted with 15 elderly patients with anal incontinence who underwent Thiersch's operation as major outpatient surgery with the use of local infiltrative anesthesia between January 2022 and July 2024.

Results: Of the 15 patients operated on, the largest number were aged 70-79 years (46.66%). Nine patients were female (60%) and six were male (40%). Anal moisture (100%) and anal irritation (86.7%) were the predominant symptoms, and all patients had some degree of prolapse. At the time of surgical diagnosis, 53.3% of patients had some degree of anal incontinence. 66.7% responded well to surgical treatment. Postoperative complications occurred in five patients, and the mesh was removed in four patients (26.7%).

Conclusions: The Thiersch operation is a simple, less invasive surgical procedure with acceptable morbidity, and should therefore be included in outpatient surgery protocols for older adults.