Results of the smooth-muscle fold-over double-plasty (SMFD)

Since 1980, when we developed substitute for the internal anal sphicter, the smooth-muscle fold-over double-plasty (SMFD-plasty), we have operated on seven children using this method, usually in combination with the pull-through procedure, and on five children after one or more previous operations. Since 1983, 11 cases with previous operations have undergone the modified “door-wing” SMFD-plasty. The results are excellent if the operation is used in primary combination with the pull-through procedure or if the “door-wing” modification is combined with reconstruction of the pelvic floor. It is also necessary that all cases undergo a biofeedback conditioning program.