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Ileal pouch-anal anastomosis (IPAA) is a standardized operation for patients with ulcerative colitis (UC). Since this operation is associated with varying degree of incontinence, an intact anal sphincter is essential. Does sphincteroplasty help?We report two cases of IPAA performed for intractable UC withpre-existing sphincter injury treated by sphincteroplasty.Case 1: 48-year-old with a 4th degree laceration from a vaginal delivery 18 yearspreviously. Nine months after IPAA, sphincteroplasty with perineoplasty was performed, and the ileostomy closed 3 months later. After 9 years' f/u, her Wexner score was eight, maximum restingpressure (MRP) 38 mmHg, and maximum squeezepressure (MSP) 75 mmHg. Case 2: A 43-year-old woman had anterior sphincter afterprevious rectovaginal fistula operation 7 years ago. Ten months after IPAA, she underwent sphincteroplasty with Z-plasty of the perineum before closure of diverting loop ileostomy. At 9 year F/U, her Wexner score was four, and MRP and MSP, 56.9 mmHg and 103.4 mmHg respectively. Both patients were satisfied with the results of operation.Our experience with two patients suggests that anal sphincteroplasty after IPAA is feasible in UC patients withpre-existing or postoperative sphincter defect, and that long-term satisfaction can be achieved.