Clin Colon Rectal Surg 2014; 27(03): 106-109
DOI: 10.1055/s-0034-1383902
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgical Management for Fecal Incontinence

Joselin L. Anandam
1   Section of Colon and Rectal Surgery, Parkland Memorial Hospital, UT Southwestern School of Medicine, Dallas, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
24 September 2014 (online)

Abstract

Fecal incontinence is a socially debilitating condition that can lead to social isolation, loss of self-esteem and self-confidence, and depression in an otherwise healthy person. After the appropriate clinical evaluation and diagnostic testing, medical management is initially instituted to treat fecal incontinence. Once medical management fails, there are a few surgical procedures that can be considered. This article is devoted to the various surgical options for fecal incontinence including the history, technical details, and studies demonstrating the complication and success rate.

 
  • References

  • 1 Parks AG, McPartlin JF. Late repair of injuries of the anal sphincter. Proc R Soc Med 1971; 64: 1187-1189
  • 2 Fang DT, Nivatvongs S, Vermeulen FD, Herman FN, Goldberg SM, Rothenberger DA. Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum 1984; 27 (11) 720-722
  • 3 Sangalli MR, Marti MC. Results of sphincter repair in postobstetric fecal incontinence. J Am Coll Surg 1994; 179 (5) 583-586
  • 4 Ctercteko GC, Fazio VW, Jagelman DG, Lavery IC, Weakley FL, Melia M. Anal sphincter repair: a report of 60 cases and review of the literature. Aust N Z J Surg 1988; 58 (9) 703-710
  • 5 Hasegawa H, Yoshioka K, Keighley MR. Randomized trial of fecal diversion for sphincter repair. Dis Colon Rectum 2000; 43 (7) 961-964 , discussion 964–965
  • 6 Lewicky CE, Valentin C, Saclarides TJ. Sexual function following sphincteroplasty for women with third- and fourth-degree perineal tears. Dis Colon Rectum 2004; 47 (10) 1650-1654
  • 7 Malouf AJ, Norton CS, Engel AF, Nicholls RJ, Kamm MA. Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet 2000; 355 (9200) 260-265
  • 8 Bravo Gutierrez A, Madoff RD, Lowry AC, Parker SC, Buie WD, Baxter NN. Long-term results of anterior sphincteroplasty. Dis Colon Rectum 2004; 47 (5) 727-731 , discussion 731–732
  • 9 Womack NR, Morrison JF, Williams NS. Prospective study of the effects of postanal repair in neurogenic faecal incontinence. Br J Surg 1988; 75 (1) 48-52
  • 10 Browning GG, Parks AG. Postanal repair for neuropathic faecal incontinence: correlation of clinical result and anal canal pressures. Br J Surg 1983; 70 (2) 101-104
  • 11 Setti Carraro P, Kamm MA, Nicholls RJ. Long-term results of postanal repair for neurogenic faecal incontinence. Br J Surg 1994; 81 (1) 140-144
  • 12 Rieger NA, Sarre RG, Saccone GT, Hunter A, Toouli J. Postanal repair for faecal incontinence: long-term follow-up. Aust N Z J Surg 1997; 67 (8) 566-570
  • 13 Fleshner PR, Roberts PL. Encirclement procedure for fecal incontinence. Perspect Colon Rectal Surg 1991; 4: 280-287
  • 14 Hallan RI, George B, Williams NS. Anal sphincter function: fecal incontinence and its treatment. Surg Annu 1993; 25 (Pt 2) 85-115
  • 15 Rongen MJ, Uludag O, El Naggar K, Geerdes BP, Konsten J, Baeten CG. Long term follow up of dynamic graciloplasty for fecal incontinence. Dis Colon Rectum 2003; 46 (6) 716-721
  • 16 Cavina E, Seccia M, Evangelista G , et al. Perineal colostomy and electrostimulated gracilis “neosphincter” after abdomino-perineal resection of the colon and anorectum: a surgical experience and follow-up study in 47 cases. Int J Colorectal Dis 1990; 5 (1) 6-11
  • 17 Baeten CGMI, Geerdes BP, Adang EMM , et al. Anal dynamic graciloplasty in the treatment of intractable fecal incontinence. N Engl J Med 1995; 332 (24) 1600-1605
  • 18 Violi V, Boselli AS, De Bernardinis M , et al. Surgical results and functional outcome after total anorectal reconstruction by double graciloplasty supported by external-source electrostimulation and/or implantable pulse generators: an 8-year experience. Int J Colorectal Dis 2004; 19 (3) 219-227
  • 19 Matzel KE, Madoff RD, LaFontaine LJ , et al; Dynamic Graciloplasty Therapy Study Group. Complications of dynamic graciloplasty: incidence, management, and impact on outcome. Dis Colon Rectum 2001; 44 (10) 1427-1435
  • 20 Hakelius L, Olsen L. Free autogenous muscle transplantation in children. Long-term results. Eur J Pediatr Surg 1991; 1 (6) 353-357
  • 21 Wong WD, Congliosi SM, Spencer MP , et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. Dis Colon Rectum 2002; 45 (9) 1139-1153
  • 22 Devesa JM, Rey A, Hervas PL , et al. Artificial anal sphincter: complications and functional results of a large personal series. Dis Colon Rectum 2002; 45 (9) 1154-1163
  • 23 Parker SC, Spencer MP, Madoff RD, Jensen LL, Wong WD, Rothenberger DA. Artificial bowel sphincter: long-term experience at a single institution. Dis Colon Rectum 2003; 46 (6) 722-729
  • 24 Takahashi T, Garcia-Osogobio S, Valdovinos MA , et al. Radio-frequency energy delivery to the anal canal for the treatment of fecal incontinence. Dis Colon Rectum 2002; 45 (7) 915-922
  • 25 Takahashi-Monroy T, Morales M, Garcia-Osogobio S , et al. SECCA procedure for the treatment of fecal incontinence: results of five-year follow-up. Dis Colon Rectum 2008; 51 (3) 355-359
  • 26 Tjandra JJ, Lim JF, Hiscock R, Rajendra P. Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction is effective. Dis Colon Rectum 2004; 47 (12) 2138-2146
  • 27 Graf W, Mellgren A, Matzel KE, Hull T, Johansson C, Bernstein M ; NASHA Dx Study Group. Efficacy of dextranomer in stabilised hyaluronic acid for treatment of faecal incontinence: a randomised, sham-controlled trial. Lancet 2011; 377 (9770) 997-1003
  • 28 Matzel KE, Stadelmaier U, Hohenfellner M, Gall FP. Electrical stimulation for the treatment of fecal incontinence. Lancet 1995; 346: 1124-1127
  • 29 Ratto C, Grillo E, Parello A, Petrolino M, Costamagna G, Doglietto GB. Sacral neuromodulation in treatment of fecal incontinence following anterior resection and chemoradiation for rectal cancer. Dis Colon Rectum 2005; 48 (5) 1027-1036
  • 30 Jarrett ME, Mowatt G, Glazener CM , et al. Systematic review of sacral nerve stimulation for faecal incontinence and constipation. Br J Surg 2004; 91 (12) 1559-1569
  • 31 Norton C, Burch J, Kamm MA. Patients' views of a colostomy for fecal incontinence. Dis Colon Rectum 2005; 48 (5) 1062-1069