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[Fecal incontinence].

J Braun1, S Willis

  • 1Chirurgische Klinik, Rotes Kreuz Krankenhaus, St. Pauli Deich 24, 28199 Bremen, Germany. braun@roteskreuzkrankenhaus.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|July 20, 2004
PubMed
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Fecal incontinence management prioritizes noninvasive treatments like biofeedback and bowel programs. Surgical options are reserved for severe cases or when medical management fails, offering various repair and stimulation techniques.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pelvic Floor Rehabilitation

Background:

  • Fecal incontinence diagnosis and management necessitate a thorough understanding of underlying anatomy and pathophysiology.
  • A structured, stepwise approach is crucial for effective patient care.
  • While surgical interventions exist, noninvasive methods often provide significant relief.

Purpose of the Study:

  • To outline a methodical approach to diagnosing and managing fecal incontinence.
  • To highlight the efficacy of noninvasive treatments before considering surgical options.
  • To detail surgical strategies for specific patient populations with fecal incontinence.

Main Methods:

  • Initial management focuses on medical interventions, including biofeedback and comprehensive bowel management programs.

Related Experiment Videos

  • Physiotherapeutic techniques are less effective for severely denervated pelvic floors.
  • Surgical interventions are indicated for external sphincter defects and cases unresponsive to medical therapy.

    • Main Results:

    • Direct sphincter repair is effective for many external sphincter injuries.
    • Radio-frequency delivery, sacral nerve stimulation, and postanal plication can improve outcomes for idiopathic fecal incontinence.
    • Advanced surgical options like dynamic gracilis plasty or artificial sphincters are considered for complex cases.

    Conclusions:

    • A stepwise management strategy, starting with conservative measures, is recommended for fecal incontinence.
    • Surgical intervention is reserved for specific indications, including sphincter defects and treatment failures.
    • Various surgical techniques offer solutions for refractory fecal incontinence, tailored to patient-specific conditions.