Surgery for faecal incontinence in adults

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Clinical Trials

Background:

• Faecal incontinence is a significant health issue impacting quality of life.
• Treatment options include conservative methods and surgical interventions.
• Surgery aims to correct defects or augment sphincter function.

Purpose of the Study:

• To evaluate surgical treatments for adult faecal incontinence (excluding rectal prolapse).
• To compare surgical versus non-surgical management.
• To compare different surgical techniques.

Main Methods:

• Systematic review of randomized and quasi-randomized trials.
• Searches included major databases and handsearches of key journals and proceedings.
• Data extraction focused on incontinence changes, continence achievement, and urgency.

Main Results:

• Thirteen trials with 440 participants were included.
• Artificial bowel sphincter showed some improvement, but with small numbers.
• Most comparisons of surgical techniques lacked statistically significant differences, often due to small sample sizes.

Conclusions:

• Limited evidence exists to guide surgical treatment choices for faecal incontinence.
• Small trial sizes and methodological weaknesses hinder definitive conclusions.
• Larger, rigorous trials are necessary; optimal treatment may be multimodal.