Fecal incontinence: an up-to-date critical overview of surgical treatment options

Abstract

Careful and detailed preoperative assessment to exactly determine the etiology of incontinence and individual approach remain the cornerstones of surgical treatment of fecal incontinence nowadays.

Evolving Therapy for Fecal Incontinence

“…1,2 Although not life-threatening, it has enormous consequences on the patient_s psychologic, emotional, and social well being. 3 Patients frequently suffer from shame and embarrassment and have to plan their lives around this disorder. 2,3 As a result of social stigma and poor self-esteem, many patients are reluctant to seek medical attention.…”

“…3 Patients frequently suffer from shame and embarrassment and have to plan their lives around this disorder. 2,3 As a result of social stigma and poor self-esteem, many patients are reluctant to seek medical attention.…”

Malone Antegrade Continent Enema: An Alternative to Resection in Severe Defecation Disorders

“…[5][6][7][8] For patients undergoing colectomy, the most commonly reported complications affecting clinical outcome have been smallbowel obstruction and persistent constipation; pain, diarrhea, and incontinence also were reported. 1,[8][9][10][11] Patients with fecal incontinence who fail long-term sphincter repair (50 percent in most recent studies), [12][13][14] those who are not candidates for sphincter repair (no sphincter defect), or those who are poor candidates (postradiation therapy and postsurgery) also have poor quality of life and disabling symptoms. Their only alternative to control their fecal incontinence often is a permanent stoma, although some have advocated sacral nerve stimulation with mixed results.…”

The ProTect device in the treatment of severe fecal incontinence: preliminary results of a multicenter trial

“…The 5 patients who continued to use the device responded to a telephone interview at a median time of 6 months after the trial (range, [3][4][5][6][7][8][9][10][11]. In all cases, identical results in terms of reduction of episodes of incontinence were reported.…”

“…Current medical and surgical procedures intended for the cure of severe fecal incontinence have variable and often unpredictable results [5][6][7][8][9]. In particular, the long-term follow-up of most surgical treatments shows an inevitable decrease in the success rate [10][11][12][13].…”