Surgical reconstitution of a unilaterally avulsed symptomatic puborectalis muscle using autologous fascia lata

BACKGROUND: The puborectalis muscle is an important muscle for the maintenance of fecal continence. We present a novel surgical technique for repair of symptomatic avulsed puborectalis muscle. CASE: This woman presented with dyspareunia and fecal incontinence since the vaginal birth of her child 2 years before. The diagnosis of an avulsed right puborectalis was made by physical examination and confirmed by magnetic resonance imaging and three-dimensional ultrasonography. Fascia lata was harvested from the patient's thigh and used to reconstitute the missing portion of the puborectalis muscle. At 12 months postoperatively, the patient was continent of stool and relieved of dyspareunia. CONCLUSION: The patient's dyspareunia and fecal incontinence were alleviated by restoring normal anatomy.