Surgery for faecal incontinence in adults

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pelvic Floor Disorders

Background:

• Faecal incontinence significantly impacts quality of life, necessitating effective treatments.
• Current management includes conservative measures and surgical interventions.
• Surgical options aim to correct defects or augment sphincter function.

Purpose of the Study:

• To compare surgical versus non-surgical management of faecal incontinence in adults without rectal prolapse.
• To compare the efficacy of various surgical techniques for faecal incontinence.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials.
• Searches included major databases (Cochrane, EMBASE) and handsearched journals.
• Data extraction and quality assessment by three independent reviewers.

Main Results:

• Nine trials with 264 participants were included.
• One trial showed artificial bowel sphincter improved outcomes, but with small numbers.
• Seven trials compared different surgical techniques, with no significant differences found in primary outcomes.

Conclusions:

• A significant lack of high-quality randomized controlled trials in fecal incontinence surgery exists.
• Small sample sizes and methodological weaknesses limit current evidence.
• Larger, rigorous trials are essential to guide clinical practice for fecal incontinence surgery.