Related Experiment Videos
Bilateral gluteus maximus transposition for anal incontinence
R K Pearl1, M L Prasad, R L Nelson
1Cook County Hospital, Department of Surgery, University of Illinois, Chicago 60612.
Diseases of the Colon and Rectum
|June 1, 1991
Summary
Bilateral gluteus maximus transposition restored bowel control in most patients with complete anal incontinence. This surgical technique improved rectal sensation and voluntary muscle control, offering a viable solution for select individuals.
Area of Science:
- Colorectal Surgery
- Pelvic Floor Reconstruction
Background:
- Complete anal incontinence significantly impacts quality of life.
- Previous surgical interventions for anal incontinence have variable outcomes.
- Sphincter damage from trauma or congenital conditions necessitates advanced reconstructive options.
Purpose of the Study:
- To evaluate the efficacy of bilateral gluteus maximus transposition for treating complete anal incontinence.
- To assess functional outcomes, including continence and rectal sensation, following the procedure.
Main Methods:
- Seven patients with complete anal incontinence underwent bilateral gluteus maximus transposition without diverting colostomy.
- The gluteus maximus muscles were detached, tunneled subcutaneously around the anus, and sutured to create voluntary muscle slings.
- Indications included sphincter destruction, pudendal nerve damage, and imperforate anus.
Main Results:
- Six of seven patients regained continence to solid stool; two also achieved liquid stool continence.
- One patient demonstrated flatus control.
- Voluntary squeeze pressures improved, and rectal sensation was markedly enhanced, while resting pressures remained unchanged.
Conclusions:
- Bilateral gluteus maximus transposition is an effective surgical option for select patients with complete anal incontinence.
- The procedure successfully restores voluntary muscle function and improves rectal sensation.
- This technique offers a promising solution for improving functional outcomes and quality of life in patients with severe fecal incontinence.