Related Experiment Videos
Bilateral gluteoplasty for fecal incontinence
J M Devesa1, J M Madrid, B R Gallego
1Department of General Surgery, University Hospital Ramón y Cajal, Madrid, Spain.
Diseases of the Colon and Rectum
|August 1, 1997
Summary
Adynamic bilateral gluteoplasty offers an effective solution for fecal incontinence when sphincter repair fails. This procedure can restore continence in over half of patients, demonstrating improved anal pressures and voluntary muscle activity.
Area of Science:
- Colorectal Surgery
- Pelvic Floor Reconstruction
- Fecal Incontinence Management
Background:
- Fecal incontinence significantly impacts quality of life.
- Sphincter repair is often unsuccessful or not viable for severe cases.
- Alternative reconstructive techniques are needed for total fecal incontinence.
Purpose of the Study:
- To evaluate the clinical experience and outcomes of adynamic bilateral gluteoplasty.
- To assess the efficacy of this procedure in patients with failed or nonviable sphincter repair.
- To analyze morbidity and functional results in a cohort of patients with total fecal incontinence.
Main Methods:
- A retrospective review of 20 patients (12 women, 8 men) who underwent adynamic gluteoplasty between 1986 and 1995.
- Indications included congenital anomalies, denervation, or sphincter destruction.
- Postoperative assessment involved clinical evaluation (Pescatori grading, self-evaluation) and manometry.
Main Results:
- Morbidity included wound infection (n=7), anal stenosis (n=2), and incisional hernia (n=1).
- Of 17 evaluable patients, 53% achieved normal control (Pescatori A-1, A-2, B-1, C-1).
- Excellent or good results were reported by 55% of patients, with improved resting and squeeze anal pressures observed.
Conclusions:
- Adynamic gluteoplasty is an efficient procedure for improving fecal continence.
- It offers a higher success rate compared to other adynamic muscle transfer techniques.
- The procedure demonstrates potential for restoring voluntary muscle activity and anal tone.