Anoplasty is surgery to repair or reconstruct the anus. You might need anoplasty if scar tissue from surgery or disease has caused your anal canal to narrow (stenosis). Your child might need it if they are born with an abnormal anus.
An anoplasty is a surgical procedure to repair or reconstruct your anus. Your anus is the end of your large intestine. It’s a short length of tube (about 3 to 4 cm) surrounded by circular muscles called sphincters that push poop out of your body. Anoplasty surgery repairs defects in your anus that prevent it from working correctly. Some defects are present at birth and some are caused by injury or disease.
Anoplasty is one type of anorectal procedure. Anorectal procedures treat defects affecting your rectum and/or anus. Your rectum is the part of your large intestine that comes just before your anus. Common conditions that affect your anus can also affect your rectum, including polyps and tumors, fissures and fistulas, hemorrhoids, inflammation and stenosis. Some anoplasty procedures may involve your rectum as well.
The most common causes of anoplasty are:
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Some malformations can be corrected with a simple anoplasty shortly after birth. Babies with more complicated malformations may need several surgeries. These babies will typically have a colostomy first. The colostomy will allow them to pass poop safely through a temporary opening in their abdomen (stoma). Their healthcare providers will determine when to schedule the next surgery. After the anoplasty has healed, the colostomy will be reversed and they can begin using their anus to poop.
If you’re an adult, your surgeon may ask you to prepare for your procedure by clearing out your bowels. They’ll prescribe or recommend a bowel prep kit to help you do this. A bowel prep is an oral laxative formula that you’ll take the day before your procedure. It will clear your bowels by making you poop everything out. For most bowel preps, you’ll need to follow a special diet for several days before taking the formula. A typical diet is low fiber for two days, then only clear liquids for the last day.
The purpose of anoplasty is to restore or create a functional anal canal. Your surgeon may take different steps depending on the nature of your condition. In most cases, you’ll be under general anesthesia for the operation and lie on your stomach. Surgeons often begin by using an electric stimulator machine to stimulate contractions in the anus muscles. This helps them map the location of the two sphincter muscles that mark the two ends of your anus or where it should be.
Depending on how extensive the procedure was, you may go home the same day or stay in the hospital for a few days. You’ll have frequent follow-up visits in the weeks ahead to ensure everything is healing. You may need to perform periodic anal dilations while your anus heals. That means inserting a special dilator into your anus each day to stretch it. Dilating your new anus trains the tissues to settle at the right diameter and prevents narrowing and scarring (stenosis) during the healing process.
Short-term complications can include:
Long-term complications can include:
The healing process, including daily dilations, normally takes four to eight weeks. Daily dilations will make your anus bleed a little. This is normal and usually not very painful. Most anorectal procedures have a low pain threshold, and you’ll have medication to help manage it. You may have some constipation, and your provider may prescribe a special diet to follow during your recovery. Once the anus has completely healed, babies with colostomies will be ready for their final surgery to reverse it.
A note from Cleveland Clinic
Anal stenosis and anal malformations are rare, but it’s good to know that surgery is an option if they happen. Anoplasty is a very effective treatment when needed. Milder cases of anal stenosis may have other treatment options. If these fail, anoplasty can help. Children with more severe anorectal malformations may never have completely normal bowel function, but anoplasty can make it as near to normal as possible.
Last reviewed by a Cleveland Clinic medical professional on 10/11/2022.
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