Unstimulated Gluteus Maximus Sphincteroplasty for Bowel Incontinence

Area of Science:

• Surgical Reconstruction
• Gastroenterology
• Musculoskeletal Research

Background:

• The gluteus maximus muscle exhibits characteristics similar to type I musculature, making it suitable for anal sphincter replacement.
• Anal sphincter replacement therapy using the gluteus maximus offers potential for lasting functional results.

Purpose of the Study:

• To evaluate the efficacy of unstimulated gluteus maximus sphincteroplasty for anal incontinence reconstruction.
• To assess neosphincter reconstruction in patients with perineal colostomy.

Main Methods:

• Retrospective cohort study analyzing patient records from March 2015 to March 2020.
• Eleven patients (4 female, 7 male) underwent gluteus maximus sphincteroplasty for fecal incontinence.
• Average follow-up period was 28.46 months.

Main Results:

• All patients achieved good continence, with a mean Cleveland Clinic Florida Faecal Incontinence Score of 3.18.
• Manometry revealed improved resting pressure (44.64 mm Hg) and squeeze pressure (103.55 mm Hg).
• No patients experienced complete continence failure, required perineal pads, or made lifestyle alterations.

Conclusions:

• Gluteus maximus sphincteroplasty yields excellent continence results without implantable electrodes.
• The procedure effectively improves anal pressure and lumen occlusion with minimal patient reeducation.
• This technique is now the preferred method for anal sphincter reconstruction at the institution.