[Treatment of faecal incontinence in surgical specialist practice]

An analysis of the treatment of faecal incontinence in a surgical specialist practice with a particular interest in this disorder.

From May 2003 to December 2005, a total of 61 patients, 49 women and 12 men with a median age of 72 and 67 years, respectively, were referred for diagnosis and treatment of faecal incontinence. The median Wexner incontinence score was 11 and median quality of life score, on a visual analogue scale ranging from 0 to 10, was 5. Treatment included surgical correction of recto-anal mucosal prolapse and grade 3 to 4 haemorrhoids, medical treatment and sphincter training. Patients were followed-up by a questionnaire after a median period of 23 months (range: 18-31).

Six patients were immediately referred for hospital treatment. Ten patients in whom the result of conservative treatment was unsatisfactory were referred for treatment in specialized colorectal departments after 3-11 months. A total of 41 of the 45 patients returned the questionnaire. The median Wexner incontinence score fell from 11 to 5 (p < 0,01) and the median quality of life score dropped from 5 to 2 (p < 0,01). A total of 38 of the 51 patients who underwent conservative treatment were satisfied with the result and did not request referral to hospital for further treatment (75%; 95% confidence limit: 60-86).

Patients suffering from a moderate degree of faecal incontinence which is not obviously of traumatic origin, including childbirth, may be treated conservatively with a satisfactory result in a surgical specialist practice with special interest in this disorder.