Sphincter repair: its present place.

Faecal incontinence has become a condition of interest only in the last 30 years. In 1970 at St Mark's Hospital, there were four admissions and over the next 20 years this had risen to 55 per year. Today faecal incontinence forms a significant part of colorectal practice. The original approach in the 1970s over a 20 year period was sphincter repair. Gynaecologists and general surgeons had for many years been occupied in the reconstruction of the anal sphincter after localised traumatic injury. In the 1970s, diffuse weakness of the pelvic floor was identified and characterised by neuromuscular histology to show evidence of denervation.