[Surgical Therapy Options for Fecal Incontinence]

Incontinence - especially anal incontinence - poses a significant burden for those affected. It severely impacts the quality of life, leads to limitations in daily life, and can result in social isolation. The aetiology of anal incontinence is heterogeneous and often multifactorial. Depending on the specific genesis, the therapy requires both a high degree of personal responsibility and discipline from the patients, as well as acceptance of the condition and its causes. For the responsible professionals, it is essential to incorporate not only professional expertise but also empathy and patience into the care. It should be gently communicated to the affected individuals that a complete restoration of continence is not realistic in most cases. Anal incontinence can occur in the context of numerous systemic diseases, psychological disorders, as well as due to muscular, sensory, or neurogenic dysfunctions. It can also be a possible complication following surgical procedures. Therefore, a differentiated, interdisciplinary investigation of the causes and their interrelations is essential. Patients should be fully informed about the available therapeutic options as well as the possible limitations of treatment. The therapeutic focus remains on conservative measures. Surgical procedures should only be considered when a morphological correlate is present and the chances of success are deemed favourable. An exception is sacral nerve modulation, which can also be successfully applied in cases of idiopathic faecal incontinence. This article is intended as a practice-oriented review and is based on clinical experience as well as the analysis and summary of current scientific literature - taking into account valid guidelines.