Preoperative increase in neuromuscular jitter and outcome following surgery for faecal incontinence

Abstract

This study implies that the poor results of surgery are related to progressive denervation and that this may be assessed before operation.

Short‐ and long‐term results of secondary anterior sphincteroplasty in 33 patients with obstetric injury

“…The patients were analyzed for incontinence scores related to the degree of sphincter tear preoperatively and at short-and long-term follow-up. Respective values for sphincter tears were for grade 3a (n = 1) 14, 4 and 9, grade 3b (n = 20) 12 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), 7 (0-18) (p < 0.01) and 11 (0-18), grade 3c (n = 9) 12 (6-17), 7 (0-20), and 7 (2-15), grade 4 (n = 3) 16 (15-17), 12 (5-16) and 12 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…One of these patients had a second sphincteroplasty after 43 months, which transiently improved continence. Corresponding incontinence scores for five patients additionally operated with sphincteroplasty (n = 4) and postanal repair (n = 2) (for details see Material and Methods) were 15 (13-20), 10 (5-10) and 14 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). One of these patients had a score of 17 at long-term follow-up, despite the use of sacral nerve stimulation.…”

“…Seven patients with incontinence symptoms for at least 10 years, including two with neuropathy, had relatively high scores unaffected by surgical treatment (14, range 11-19), 13 (4-16) and 14 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Seven patients aged >50 years, of whom two had neuropathy, had a significant reduction of incontinence scores at short-term follow-up (14, (range 8-20) vs. 6 (0-15) (p < 0.05)) and still a considerable reduction at long-term follow-up (9, range 4-18).…”