{
  "abstract": "Post-obstetric fecal incontinence is multifactorial, and structural aspects related to the perineal body may not be fully characterized within current frameworks. We propose a three-type morphology-based classification and report type-stratified outcomes after perineal body reconstruction, in which the lateral extensions of the perineal body (LEPB) are reapproximated without direct sphincter manipulation. Forty-two consecutive female patients (July 2022-December 2025) with post-obstetric anal sphincter insufficiency (Wexner ≥ 4) underwent perineal body reconstruction and were classified as Type 1 (rectovaginal fistula, n = 20), Type 2 (sphincter insufficiency without fistula, n = 14), or Type 3 (cloaca-like deformity, n = 8). The primary outcome was the 6-month change in Wexner score; clinical improvement was defined as a decrease ≥ 4 points. Post-operative scores were compared by Kruskal-Wallis and post-hoc Mann-Whitney U tests with Bonferroni correction (adjusted α = 0.0167). The overall Wexner score decreased from 11.4 ± 4.7 to 3.4 ± 4.3 (p < 0.001, Cohen's d = 1.92), with a 95.2% clinical improvement rate (40/42) and 50.0% complete remission (21/42). Post-operative scores differed among types (Kruskal-Wallis, p = 0.010); after Bonferroni correction, only Type 1 vs Type 2 remained significant (raw p = 0.003; adjusted p = 0.009). Type 1, 2, and 3 improvement rates were 100%, 85.7%, and 100%. The morphology-based classification linked preoperative assessment to type-specific surgical considerations and outcome expectations. Perineal body reconstruction, which targets the connective-tissue scaffold rather than the sphincter muscle, may complement muscle-level sphincteroplasty and neuromodulation; prospective comparative evaluation is warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Surgery, Soshinkai Nagaokakyo Hospital, Nagaokakyo, Japan.",
    "Department of Digestive and General Surgery, Shiga University of Medical Science, Otsu, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Koichiro Murakami"
    },
    {
      "affs": [
        1
      ],
      "name": "Yumi Nishimura"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomoyuki Mizukuro"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4x55tprr48w51.bib",
  "cited_by": 0,
  "doi": "10.23922/jarc.2026-039",
  "fulltext_url": "https://europepmc.org/articles/PMC13713571",
  "id": "4x55tprr48w51",
  "issns": [
    "2432-3853"
  ],
  "landing_url": "https://europepmc.org/article/MED/42952902",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research Article"
    ],
    [
      "openalex",
      "2745|Pelvic floor disorders treatments"
    ]
  ],
  "openalex": "W7223442270",
  "pdf_url": "https://europepmc.org/articles/PMC13713571?pdf=render",
  "pmcid": "PMC13713571",
  "pmid": "42952902",
  "published": "2026-10-25",
  "publisher": "The Japan Society of Coloproctology",
  "ris": "https://research.draconitic.com/paper/4x55tprr48w51.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:40Z",
      "native_id": "MED:42952902",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42952902"
    },
    {
      "first_seen": "2026-10-31T12:24:06Z",
      "native_id": "PMC13713571",
      "source": "pmc",
      "url": "https://doi.org/10.23922/jarc.2026-039"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2745|Pelvic floor disorders treatments",
      "subfield": "general"
    }
  ],
  "title": "Perineal Body Reconstruction for Anal Sphincter Insufficiency Following Obstetric Perineal Body Injury: Morphology-based Classification and Type-stratified Outcomes in 42 Cases.",
  "title_text": "Perineal Body Reconstruction for Anal Sphincter Insufficiency Following Obstetric Perineal Body Injury: Morphology-based Classification and Type-stratified Outcomes in 42 Cases.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:13Z",
  "url": "https://research.draconitic.com/paper/4x55tprr48w51",
  "venue": "Journal of the anus, rectum and colon",
  "versions": []
}