[Surgical treatment of fecal incontinence]

27 patients suffering from anal incontinence (4 male, 23 female) were treated in 22 cases with suture of the anal sphincters and in 5 cases with sublevatorial implantation of a silicone ring. A questionnaire and a follow up examination 0.5-10 years (median 3.5 years) after operation were carried out. 4 patients after anal sphincter suture could not be followed. In 2 cases of sphincter suture a final colostomy had been performed. 2 silicone rings had been removed because of infection or rupture. After reconstruction of the anal sphincter 5 patients felt complete continent; 9 were continent for solid stool; 2 complained about incontinence. In the group treated with silicone ring implantation, 1 patient felt completely and 2 partially continent. Subjective assessment and objective measuring of the quality of anal continence did not correlate. For the most part the results of subjective assessment appeared less favourable than might be expected form the values measured. Objectively a rise in all anal pressure values to a normal level was in most cases detectable. Compared to prior values this increase of anal tonus is significant.