[Modern Strategies for the Treatment of Fecal Incontinence]

Area of Science:

• Gastroenterology and Colorectal Surgery

Background:

• Fecal incontinence (FI) significantly impacts patient quality of life and has an underestimated prevalence, particularly in aging populations.
• Demographic changes in Germany suggest FI will become more prevalent and impactful.
• Recent advancements in technology and evidence for existing methods necessitate an update on FI treatment options.

Purpose of the Study:

• To review and highlight current developments in fecal incontinence treatment.
• To present new therapeutic options and evidence for existing modalities.
• To provide an overview of the evolving landscape of fecal incontinence management.

Main Methods:

• A comprehensive review of recent literature on fecal incontinence treatment was conducted.
• Analysis focused on both conservative and surgical therapeutic approaches.
• Evidence for established and emerging treatments was evaluated.

Main Results:

• Combined conservative therapies are particularly effective for fecal incontinence.
• Sacral nerve stimulation demonstrates confirmed long-term efficacy and is considered a first-line surgical therapy.
• Sphincteroplasty remains an option for sphincter gap defects, though long-term efficacy is limited; bulking agents offer an alternative with limited evidence; ventral mesh rectopexy is established for masked defecation disorders.

Conclusions:

• The range of therapeutic options for fecal incontinence is continuously expanding.
• Conservative treatment is the recommended initial approach for fecal incontinence.
• Further development and evaluation of new and existing treatment options are crucial for improving fecal incontinence management.