Combined vertical reduction rectoplasty and sacral nerve stimulation for rectal evacuatory dysfunction and faecal
D J Boyle1, K A Gill, H C Ward
1The Royal London Hospital, Barts and The London NHS Trust, Whitechapel, London, England, E1 1BB, UK. d.boyle@qmul.ac.uk
Insights
This study presents a two-stage treatment for a 34-year-old female with lifelong rectal evacuatory dysfunction and fecal incontinence due to a vestibular fistula. The successful treatment resulted in efficient defecation and near-complete continence.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Colorectal surgery
Background:
- Anorectal malformation (ARM) surgery outcomes are variable.
- Many patients experience persistent anorectal dysfunction and fecal incontinence post-surgery.
- Lifelong functional deficits impact quality of life.
Observation:
- A 34-year-old female presented with a history of vestibular fistula.
- She suffered from lifelong rectal evacuatory dysfunction and fecal incontinence.
- Previous treatments had not resolved her symptoms.
Findings:
- A novel two-stage surgical approach was implemented.
- The treatment successfully restored efficient defecation.
- The patient achieved almost total fecal continence post-treatment.
Implications:
- This case demonstrates a potential effective treatment for complex adult anorectal malformations.
- The findings suggest that late-stage intervention can significantly improve functional outcomes.
- Further research into two-stage surgical strategies for ARM sequelae is warranted.
Abstract:
Functional outcomes following surgery for anorectal malformation are variable, with many children experiencing persisting anorectal dysfunction. We describe a 34-year-old female with previous vestibular fistula who experienced lifelong rectal evacuatory dysfunction and faecal incontinence; she was treated in a two stage process producing efficient defecation and almost total continence.
