Perineal Puborectalis Sling Operation for Fecal Incontinence: Preliminary Report

Yamana, Tetsuo; Takahashi, Tomoko; Iwadare, J.

doi:10.1007/s10350-004-0675-z

Cited by 27 publications

(7 citation statements)

References 29 publications

(32 reference statements)

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“…A specially designed polyester mesh sling is introduced along the puborectalis muscle, from a posterior perianal incision running to a small suprapubic incision. The ends are tied together with moderate tension [45]. This operation is very similar to the original puborectoplasty reported by Shafik in 1991 [46].…”

Section: Minimally Invasive Innovative and Experimental Techniquesmentioning

confidence: 88%

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

Muller

Belyaev

Deska

et al. 2005

Langenbecks Arch Surg

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Section: Minimally Invasive Innovative and Experimental Techniquesmentioning

confidence: 88%

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

Muller

Belyaev

Deska

et al. 2005

Langenbecks Arch Surg

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“…In a study with eight patients [60], a mesh was placed between the internal and external anal sphincter muscles, and rectal ulcer developed in one patient, necessitating sling removal. In the remaining seven patients, the FI score (FISI, CCFIS) and QOL score (FIQL) significantly improved.…”

Section: Discussionmentioning

confidence: 99%

Japanese Practice Guidelines for Fecal Incontinence Part 3 -Surgical Treatment for Fecal Incontinence, Fecal Incontinence in a Special Conditions- English Version

Maeda

Katsuno

Tsunoda

et al. 2021

J Anus Rectum Colon

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In Japan, the surgical treatment for fecal incontinence (FI) can be performed using minimally invasive surgery, such as anal sphincteroplasty and sacral neuromodulation (SNM), as well as antegrade continence enema (ACE), graciloplasty, and stoma construction. In addition, currently, several other procedures, including biomaterial injection therapy, artificial bowel sphincter (ABS), and magnetic anal sphincter (MAS), are unavailable in Japan but are performed in Western countries. The evidence level of surgical treatment for FI is generally low, except for novel procedures, such as SNM, which was covered by health insurance in Japan since 2014. Although the surgical treatment algorithm for FI has been chronologically modified, it should be sequentially selected, starting from the most minimally invasive procedure, as FI is a benign condition. Injuries to the neural system or spinal cord often cause disorders of the sensory and motor nerves that innervate the anus, rectum, and pelvic floor, leading to the difficulty in controlling bowel movement or FI and/or constipation. FI and constipation are closely associated; when one improves, the other tends to deteriorate. Patients with severe cognitive impairment may present with active soiling, referred to as “incontinence” episodes that occur as a consequence of abnormal behavior, and may also experience passive soiling.

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“…Successful treatment of FI with a perineal puborectalis sling has been reported in pilot studies. 72 This procedure is started by making a 3-to 4-cm curvilinear incision posterior to the anus and by opening the intrasphincteric spaces bilaterally. A 2-cm suprapubic incision is made and a trochar is passed on either side of the rectum from the perineum to the suprapubic incision.…”

Section: Posterior Anal Slingmentioning

confidence: 99%

Fecal Incontinence: Epidemiology, Impact, and Treatment

Bochenska

Boller

2016

Clinics in Colon and Rectal Surgery

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Fecal incontinence (FI) is a chronic and debilitating condition that carries a significant health, economic, and social burden. A variety of treatment modalities for FI are available. Definitions and EtiologyFI is the symptom of involuntary loss of feces which includes (a) solid feces; (2) liquid feces; (3) passive FI defined as soiling without sensation or warning or difficulty wiping clean; and (4) coital FI. Additionally, flatal incontinence is defined as the involuntary loss of flatus; and fecal urgency is a sudden compelling, difficult to defer desire to defecate. 1 The primary factors necessary for fecal continence are an enteric content that is substantially firm and bulky, a passively distensible reservoir which is capable of evacuation, and an effective barrier to outflow. Therefore, changes in the quantity or quality of stool presented to the sphincter, the inability of the rectum to accommodate stool, damage to the anal sphincter mechanism, or an impaired sensation can result in FI. 2 As a result, common etiologies of FI include diarrhea, decreased rectal compliance (i.e., ulcerative proctitis and radiation proctitis), anal sphincter damage (i.e., trauma, obstetrical injury, and surgery), decreased perception of rectal sensation (i.e., spinal cord injury, multiple sclerosis, and diabetes mellitus), and overflow incontinence secondary to fecal retention and impaction. Other contributing factors may include psychosis with willful soiling, medication effects (i.e., laxatives, anticholinergics, antidepressants, and caffeine), and food intolerance (lactose, fructose, and sorbitol). It is also important to note that FI is often multifactorial and, thus, multiple conditions may be contributing to patients' symptoms. EpidemiologyAccurate reporting of the incidence and prevalence of FI is challenging due to variations in the definitions of FI and the populations studied. Ng et al recently completed a systematic review on the prevalence of and factors associated with FI among community-dwelling adults. Across all 38 studies included in the review, the median prevalence of FI was 7.7%; however, this prevalence ranged from 2.0 to 20.7%. This wide range is reflective of the substantial heterogeneity of diagnostic criteria, population characteristics, and study design between the included studies. In this review, FI equally affected men (median, 8.1%; range, 2.3-16.1%) and women (median, 8.9%; range, 2.0-20.7%) AbstractFecal incontinence (FI) is a chronic and debilitating condition that carries a significant health, economic, and social burden. FI has a considerable psychosocial and financial impact on patients and their families. A variety of treatment modalities are available for FI including behavioral and dietary modifications, pharmacotherapy, pelvic floor physical therapy, bulking agents, anal sphincteroplasty, sacral nerve stimulation, artificial sphincters, magnetic sphincters, posterior anal sling, and colostomy.

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Perineal Puborectalis Sling Operation for Fecal Incontinence: Preliminary Report

Abstract: We believe that the perineal puborectalis sling operation is technically feasible, with low morbidity, and can be an effective procedure for idiopathic fecal incontinence.

Cited by 27 publications

References 29 publications

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

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

Japanese Practice Guidelines for Fecal Incontinence Part 3 -Surgical Treatment for Fecal Incontinence, Fecal Incontinence in a Special Conditions- English Version

Fecal Incontinence: Epidemiology, Impact, and Treatment

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