Platelet-Rich Plasma in Sphincteroplasty

In this article, I review the interesting manuscript titled “Effects of Platelet-Rich Plasma on Healing of Sphincteroplasty: An Experiment in Rabbit Model” (1) about application of Platelet-Rich Plasma in anal sphincteroplasty. While reviewing the article in which a novel idea was proposed for improving the outcome of sphincteroplasty, three issues were questionable for me: The first issue is the site of sphincterotomy, which was mentioned as the posterior midline. It is known that the external anal sphincter is connected posteriorly to the anococcygeal ligament (2), and division at this point is not always associated with separation of the sphincter and fecal incontinence. The second is that animal experiments on the anal sphincter are different on the basis of sphincter function rather than anatomically, and if sphincterotomy is done on an animal, then the impaired functioning should be demonstrated (3) before further intervention. Due to the small size of the sphincter complex in small animals, it is sometimes hard to understand the exact territory of the muscle.