Abstract
Introduction
Fecal incontinence is a debilitating problem that has many different causes. There also are many treatments options, from behavioral modification to sphincteroplasty to artificial anal sphincter and colostomy. In a society with an aging population, fecal incontinence is an ever-increasing problem and will continue to grow.
Discussion
Treatment plans need to be individually tailored for each patient. The surgeon should be proficient in different types of procedures and match the procedure with the needs of the patient. Long-term follow-up of these patients must continue to help us better serve this patient population.
Similar content being viewed by others
References
Jackson SL, Hull TL (1998) Fecal incontinence in women. Obstet Gynecol Surg 53:741–747
Johanson JF, Lafferty J (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91:33–36
Tan JJ, Chan M, Tjandra JJ (2007) Evolving therapy for fecal incontinence. Dis Colon Rectum 50:1950–1967
Johanson JF, Irizarry F, Doughty A (1997) Risk factors for fecal incontinence in a nursing home population. J Clin Gastroenterol 24:156–160
Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI (1993) Anal-sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911
Mahony R, Behan M, Daly L, Kirwan C, O’Herlihy C, O’Connell PR (2007) Internal anal sphincter defect influences continence outcome following obstetric anal sphincter injury. Am J Obstet Gynecol 196:217–215
Fitzpatrick M, Behan M, O'connell PR, O'herlihy C (2003) Randomised clinical trial to assess anal sphincter function following forceps or vacuum assisted vaginal delivery. BJOG 110:424–429
Hahnloser D, Pemberton JH, Wolff BG, Larson D, Harrington J, Farouk R, Dozois RR (2004) Pregnancy and delivery before and after ileal pouch–anal anastomosis for inflammatory bowel disease: immediate and long-term consequences and outcomes. Dis Colon Rectum 47:1127–1135
Ravid A, Richard CS, Spencer LM, O'Connor BI, Kennedy ED, MacRae HM, Cohen Z, McLeod RS (2002) Pregnancy, delivery, and pouch function after ileal pouch–anal anastomosis for ulcerative colitis. Dis Colon Rectum 45:1283–1288
Remzi FH, Gorgun E, Bast J, Schroeder T, Hammel J, Philipson E et al (2005) Vaginal delivery after ileal pouch–anal anastomosis: a word of caution. Dis Colon Rectum 48:1691–1699
Rudolph W, Galandiuk S (2002) A practical guide to the diagnosis and management of fecal incontinence. Mayo Clin Proc 77:271–275
Hinninghofen H, Enck P (2003) Fecal incontinence: evaluation and treatment. Gastroenterol Clin North Am 32:685–706
Felt-Bersma RJ, Klinkenberg-Knol EC, Meuwissen SG (1990) Anorectal function investigations in incontinent and continent patients. Differences and discriminatory value. Dis Colon Rectum 33:479–485
Bliss DZ, McLaughlin J, Jung HJ, Lowry A, Savik K, Jensen L (2000) Comparison of the nutritional composition of diets of persons with fecal incontinence and that of age- and gender-matched controls. J Wound Ostomy Continence Nurs 27:90–97
Loening-Baucke V (1990) Biofeedback therapy for fecal incontinence. Dig Dis 8:112–124
Wald A (2007) Clinical practice. Fecal incontinence in adults. N Engl J Med 356:1648–1655
Heymen S, Jones KR, Ringel Y, Scarlett Y, Whitehead WE (2001) Biofeedback treatment of fecal incontinence: a critical review. Dis Colon Rectum 44:728–736
Ryn AK, Morren GL, Hallbook O, Sjodahl R (2000) Long-term results of electromyographic biofeedback training for fecal incontinence. Dis Colon Rectum 43:1262–1266
Pager CK, Solomon MJ, Rex J, Roberts RA (2002) Long-term outcomes of pelvic floor exercise and biofeedback treatment for patients with fecal incontinence. Dis Colon Rectum 45:997–1003
Ehrenpreis ED, Chang D, Eichenwald E (2007) Pharmacotherapy for fecal incontinence: a review. Dis Colon Rectum 50:641–649
Tjandra JJ, Dykes SL, Kumar RR, Ellis CN, Gregorcyk SG, Hyman NH, Buie WD, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons (2007) Practice parameters for the treatment of fecal incontinence. Dis Colon Rectum 50:1497–1507
Santoro GA, Eitan BZ, Pryde A, Bartolo DC (2000) Open study of low-dose amitriptyline in the treatment of patients with idiopathic fecal incontinence. Dis Colon Rectum 43:1676–1681
Carapeti EA, Kamm MA, Nicholls RJ, Phillips RK (2000) Randomized, controlled trial of topical phenylephrine for fecal incontinence in patients after ileoanal pouch construction. Dis Colon Rectum 43:1059–1063
Altomare DF, La TF, Rinaldi M, Binda GA, Pescatori M (2008) Carbon-coated microbeads anal injection in outpatient treatment of minor fecal incontinence. Dis Colon Rectum 51:432–435
Takahashi-Monroy T, Morales M, Garcia-Osogobio S, Valdovinos MA, Belmonte C, Barreto C, Zarate X, Bada O, Velasco L (2008) SECCA(R) procedure for the treatment of fecal incontinence: results of five-year follow-up. Dis Colon Rectum 51:355–359
Browning GG, Motson RW (1984) Anal sphincter injury. Management and results of Parks sphincter repair. Ann Surg 199:351–357
Christiansen J, Pedersen IK (1987) Traumatic anal incontinence: results of surgical repair. Dis Colon Rectum 30:189–191
Ctercteko GC, Fazio VW, Jagelman DG, Lavery IC, Weakley FL, Melia M (1988) Anal sphincter repair: a report of 60 cases and review of the literature. Aust N Z J Surg 58:703–710
Engel AF, Brummelkamp WH (1994) Secondary surgery after failed postanal or anterior sphincter repair. Int J Colorectal Dis 9:187–190
Engel AF, van Baal SJ, Brummelkamp WH (1994) Late results of anterior sphincter plication for traumatic faecal incontinence. Eur J Surg 160:633–636
Fang DT, Nivatvongs S, Vermeulen FD, Herman FN, Goldberg SM, Rothenberger DA (1984) Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum 27:720–722
Fleshman JW, Peters WR, Shemesh EI, Fry RD, Kodner IJ (1991) Anal sphincter reconstruction: anterior overlapping muscle repair. Dis Colon Rectum 34:739–743
Hawley PR (1985) Anal sphincter reconstruction. Langenbecks Arch Chir 366:269–272
Jacobs PP, Scheuer M, Kuijpers JH, Vingerhoets MH (1990) Obstetric fecal incontinence. Role of pelvic floor denervation and results of delayed sphincter repair. Dis Colon Rectum 33:494–497
Londono-Schimmer EE, Garcia-Duperly R, Nicholls RJ, Ritchie JK, Hawley PR, Thomson JP (1994) Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five year follow-up functional results. Int J Colorectal Dis 9:110–113
Simmang C, Birnbaum EH, Kodner IJ, Fry RD, Fleshman JW (1994) Anal sphincter reconstruction in the elderly: does advancing age affect outcome? Dis Colon Rectum 37:1065–1069
Nikiteas N, Korsgen S, Kumar D, Keighley MR (1996) Audit of sphincter repair. Factors associated with poor outcome. Dis Colon Rectum 39:1164–1170
Sangwan YP, Coller JA, Barrett RC, Roberts PL, Murray JJ, Rusin L et al (1996) Unilateral pudendal neuropathy. Impact on outcome of anal sphincter repair. Dis Colon Rectum 39:686–689
Sangwan YP, Coller JA, Barrett MS, Murray JJ, Roberts PL, Schoetz DJ Jr (1996) Unilateral pudendal neuropathy. Significance and implications. Dis Colon Rectum 39:249–251
Halverson AL, Hull TL (2002) Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 45:345–348
Barisic GI, Krivokapic ZV, Markovic VA, Popovic MA (2006) Outcome of overlapping anal sphincter repair after 3 months and after a mean of 80 months. Int J Colorectal Dis 21:52–56
Jensen LL, Lowry AC (1997) Biofeedback improves functional outcome after sphincteroplasty. Dis Colon Rectum 40:197–200
Khanduja KS, Padmanabhan A, Kerner BA, Wise WE, Aguilar PS (1999) Reconstruction of rectovaginal fistula with sphincter disruption by combining rectal mucosal advancement flap and anal sphincteroplasty. Dis Colon Rectum 42:1432–1437
Penninckx F (1992) Fecal incontinence: indications for repairing the anal sphincter. World J Surg 16:820–825
Matsuoka H, Mavrantonis C, Wexner SD, Oliveira L, Gilliland R, Pikarsky A (2000) Postanal repair for fecal incontinence—is it worthwhile? Dis Colon Rectum 43:1561–1567
Abbas SM, Bissett IP, Neill ME, Parry BR (2005) Long-term outcome of postanal repair in the treatment of faecal incontinence. ANZ J Surg 75:783–786
Engel AF, van Baal SJ, Brummelkamp WH (1994) Late results of postanal repair for idiopathic faecal incontinence. Eur J Surg 160:637–640
Baeten CG, Bailey HR, Bakka A, Belliveau P, Berg E, Buie WD, Burnstein MJ, Christiansen J, Coller JA, Galandiuk S, LaFontaine LJ, Lange J, Madoff RD, Matzel KE, Påhlman L, Parc R, Reilly JC, Seccia M, Thorson AG, Vernava AM 3rd, Wexner S (2000) Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum 43:743–751
Wexner SD, Baeten C, Bailey R, Bakka A, Belin B, Belliveau P Berg E, Buie WD, Burnstein M, Christiansen J, Coller J, Galandiuk S, Lange J, Madoff R, Matzel KE, Påhlman L, Parc R, Reilly J, Seccia M, Thorson AG, Vernava AM 3rd (2002) Long-term efficacy of dynamic graciloplasty for fecal incontinence. Dis Colon Rectum 45:809–818
Niriella DA, Deen KI (2000) Neosphincters in the management of faecal incontinence. Br J Surg 87:1617–1628
Devesa JM, Rey A, Hervas PL, Halawa KS, Larranaga I, Svidler L, Abraira V, Muriel A (2002) Artificial anal sphincter: complications and functional results of a large personal series. Dis Colon Rectum 45:1154–1163
Gordon PH (1999) Anal incontinence. In: Gordon PH, Nivatvongs S (ed) Principles of surgery for the colon, rectum, and anus, 2nd edn. Taylor and Francis, London
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Galandiuk, S., Roth, L.A. & Greene, Q.J. Anal incontinence—sphincter ani repair: indications, techniques, outcome. Langenbecks Arch Surg 394, 425–433 (2009). https://doi.org/10.1007/s00423-008-0332-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00423-008-0332-4