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Faecal incontinence 1994: which test and which treatment?
1Department of Surgery, Free University Hospital, Amsterdam, Netherlands.
The Netherlands Journal of Medicine
|May 1, 1994
Summary
Faecal incontinence stems from various causes like sphincter damage or nerve issues. Advanced diagnostics like anal endosonography and defaecography aid in diagnosis and guide surgical repair for improved patient outcomes.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Faecal incontinence is a prevalent and disabling condition.
- It results from multiple factors including sphincter damage, neuropathy, reduced rectal compliance, impaction, and neurological diseases.
- Diarrhea can also contribute to or exacerbate faecal incontinence.
Purpose of the Study:
- To outline the causes and diagnostic approaches for faecal incontinence.
- To highlight the role of anorectal function tests, anal endosonography, and defaecography.
- To discuss current and emerging surgical treatments for faecal incontinence.
Main Methods:
- Clinical evaluation including medical history and physical examination.
- Anorectal function tests: anal manometry, rectal compliance measurement, anal mucosal sensitivity, and neurophysiological tests.
- Imaging techniques: anal endosonography and defaecography.
Main Results:
- Medical history and physical exam often suggest a diagnosis.
- Anorectal function tests reveal abnormalities like low sphincter pressures, reduced rectal volume, high sensitivity thresholds, and delayed nerve latency.
- Anal endosonography detects sphincter defects, while defaecography identifies intussusception, both guiding surgical interventions.
Conclusions:
- A systematic work-up is crucial for diagnosing faecal incontinence.
- Anal endosonography and defaecography are vital tools for identifying specific pathologies.
- Surgical options range from classic repairs to newer techniques like dynamic gracilis repair, with promising outcomes.