Surgical Technique
Surgical repair was performed by the five senior authors (PD, JK, LS, AD and AW). A midline incision was made on the lower posterior vaginal wall and perineum; the remnants of the external anal sphincter were identified and dissected out to 3’ and 9’clock. An overlapping AS repair was performed using 2/0 PDS. A concomitant posterior colporrhaphy +/- perineorrhaphy was performed in all patients.