Skip to main content

Advertisement

SpringerLink
Log in

Evolving Therapy for Fecal Incontinence

  • Current Status
  • W. Donald Buie, M.D., Editor
  • Published:
Diseases of the Colon & Rectum

Abstract

Background

Fecal incontinence is common and can be socially debilitating. Nonoperative management of fecal incontinence includes dietary modification, antidiarrheal medication, and biofeedback. The traditional surgical approach is sphincteroplasty if there is a defect of the external sphincter. Innovative treatment modalities have included sacral nerve stimulation, injectable implants, dynamic graciloplasty, and artificial bowel sphincter.

Discussion

This review was designed to assess the various surgical options available for fecal incontinence and critically evaluate the evidence behind these procedures. The algorithm in the surgical treatment of fecal incontinence is shifting. Injectable therapy and sacral nerve stimulation are likely to be the mainstay in future treatment of moderate and severe fecal incontinence, respectively. Sphincteroplasty is limited to a small group of patients with isolated defect of the external sphincter. A stoma, although effective, can be avoided in most cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. Madoff RD, Parker SC, Varma MG, Lowry AL. Faecal incontinence in adults. Lancet 2004;364:621-2.

    Article  PubMed  Google Scholar 

  2. Rao SS. Diagnosis and management of fecal incontinence. Am J Gastroenterol 2004;99:1585-04.

    Article  PubMed  Google Scholar 

  3. Muller C, Belyaev O, Deska T, Chromik A, Wayhe D, Uhl W. Fecal incontinence: an up-to-date critical overview of surgical treatment options. Langenbecks Arch Surg 2005;390:544-2.

    Article  PubMed  Google Scholar 

  4. Steele RJ, Campbell KL. Managing faecal incontinence. BMJ 2005;330:207-.

    Article  PubMed  Google Scholar 

  5. Nelson R, Norton N, Cautley E, Furner S. Community-based prevalence of anal incontinence. JAMA 1995;274:559-1.

    Article  PubMed  CAS  Google Scholar 

  6. Ho YH, Muller R, Veitch C, Rane A, Durrheim D. Faecal incontinence: an unrecognized epidemic in rural North Queensland? Results of a hospital-based outpatient study. Aust J Rural Health 2005;13:28–34.

    Article  PubMed  Google Scholar 

  7. Siproudhis L, Pigot F, Godeberge P, Damon H, Saudan D, Bigard MA. Defecation disorders: a French population survey. Dis Colon Rectum 2006;49:219-7.

    Article  PubMed  Google Scholar 

  8. Kalantar JS, Howell S, Talley NJ. Prevalence of fecal incontinence and associated risk factors. An underdiagnosed problem in the Australian community? Med J Aust 2001;176:54-.

    Google Scholar 

  9. Borrie MJ, Davidson HA. Incontinence in institutions: costs and contributing factors. CMAJ 1992;147:322-.

    PubMed  CAS  Google Scholar 

  10. Nelson RL. Epidemiology of fecal incontinence. Gastroenterology 2004;126:S3-.

    Article  PubMed  Google Scholar 

  11. Porell F, Caro FG, Silva A, Monane M. A longitudinal analysis of nursing home outcomes. Health Serv Res 1998;33:835-5.

    PubMed  CAS  Google Scholar 

  12. Melville JL, Fan MY, Newton K, Fenner D. Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol 2005;193:2071-.

    Article  PubMed  Google Scholar 

  13. Bharucha AE, Zinsmeister AR, Locke GR, et al. Prevalence and burden of fecal incontinence: a population-based study in women. Gastroenterology 2005;129:42-.

    Article  PubMed  Google Scholar 

  14. Quander CR, Morris MC, Melson J, Bienias JL, Evans DA. Prevalence of and factors associated with fecal incontinence in a large community study of older individuals. Am J Gastroenterol 2005;100:905-.

    Article  PubMed  Google Scholar 

  15. Bharucha AE, Fletcher JG, Harper CM, et al. Relationship between symptoms and disordered continence mechanisms in women with idiopathic faecal incontinence. Gut 2005;54:546-5.

    Article  PubMed  CAS  Google Scholar 

  16. Rao SS, Patel RS. How useful are manometric tests of anorectal function in the management of defecation disorders. Am J Gastroenterol 1997;92:469-5.

    PubMed  CAS  Google Scholar 

  17. Kamm MA. Obstetric damage and fecal incontinence. Lancet 1994;344:730-.

    Article  PubMed  CAS  Google Scholar 

  18. Sultan AH, Kamm MA, Hudson CN, Bartram CI. Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair. Br Med J 1994;308:887-1.

    PubMed  CAS  Google Scholar 

  19. Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI. Anal-sphincter disruption during vaginal delivery. N Engl J Med 1993;329:1905-1.

    Article  PubMed  CAS  Google Scholar 

  20. Mazouni C, Bretelle F, Battar S, Bonnier P, Gamerre M. Frequency of persistent anal symptoms after first instrumental delivery. Dis Colon Rectum 2005;48:1432-.

    Article  PubMed  Google Scholar 

  21. Nyam DC, Pemberton JH. Long-term results of lateral internal sphincterotomy for chronic anal fissure with particular reference to incidence of fecal incontinence. Dis Colon Rectum 1999;42:1306-0.

    Article  PubMed  CAS  Google Scholar 

  22. Garcia-Aguilar J, Belmonte C, Wong WD, et al. Open vs. closed sphincterotomy for chronic anal fissure: long-term results. Dis Colon Rectum 1996;39:440-.

    Article  PubMed  CAS  Google Scholar 

  23. Lindsey I, Jones OM, Smilgin-Humphreys MM, et al. Patterns of fecal incontinence after anal surgery. Dis Colon Rectum 2004;47:1643-.

    Article  PubMed  Google Scholar 

  24. Casillas S, Hull TL, Zutshi M, et al. Incontinence after a lateral internal sphincterotomy: are we underestimating it? Dis Colon Rectum 2005;48:1193-.

    Article  PubMed  Google Scholar 

  25. Engel AF, Kamm MA, Hawley PR. Civilian and war injuries of the perineum and anal sphincters. Br J Surg 1994;81

    Article  PubMed  CAS  Google Scholar 

  26. Caruana BJ, Wald A, Hinds J, et al. Anorectal sensory and motor function in neurogenic fecal incontinence. Comparison between multiple sclerosis and diabetes mellitus. Gastroenterology 1991;100:465-0.

    PubMed  CAS  Google Scholar 

  27. Lundby L, Krogh K, Jensen VJ, et al. Long-term anorectal dysfunction after postoperative radiotherapy for rectal cancer. Dis Colon Rectum 2005;48:1343-.

    Article  PubMed  Google Scholar 

  28. Bharucha AE, Zinsmeister AR, Luke GR. Risk factors for fecal incontinence : a population-based study in women. Am J Gastroenterol 2006;101:1305-2.

    Article  PubMed  Google Scholar 

  29. Sultan AH, Nugent K. Pathophysiology and nonsurgical treatment of anal incontinence. BJOG 2004;111(Suppl):84–90

    PubMed  Google Scholar 

  30. Wald A. Fecal incontinence. Curr Treat Options Gastroenterol 2005;8:319-4.

    Article  PubMed  Google Scholar 

  31. Leung FW, Rao SS. Fecal incontinence. In: Mezey ME, Berkman BJ, Callahan CM, et al. The encyclopedia of elder care: the comprehensive resource on geriatric and social care. New York: Springer, 2001:261-.

    Google Scholar 

  32. Cheetham M, Brazzelli M, Norton C, Glazener CM. Drug treatment for fecal incontinence. Cochrane Database Syst Rev 2003;3:CD002116.

    PubMed  Google Scholar 

  33. Heymen S, Jones KR, Ringel Y, Scarlett Y, Whitehead WE. Biofeedback treatment of fecal incontinence: a critical review. Dis Colon Rectum 2001;44:728-6.

    Article  PubMed  CAS  Google Scholar 

  34. Whitehead WE, Burgio KL, Engel BT. Biofeedback treatment of fecal incontinence in geriatric patients. J Am Geriatr Soc 1985;33:320-.

    PubMed  CAS  Google Scholar 

  35. McHugh S, Walma K, Diamant NE. Fecal incontinence: a controlled trial of biofeedback. Gastroenterology 1986;90:154-.

    Google Scholar 

  36. Norton C, Kamm MA. Outcome of biofeedback for faecal incontinence. Br J Surg 1999;86:1159-3.

    Article  PubMed  CAS  Google Scholar 

  37. Norton C, Chelvanayagam S, Wilson-Barnett J, Redfern S, Kamm MA. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology 2003;125:1320-.

    Article  PubMed  Google Scholar 

  38. Mortensen N, Humphreys MS. The anal continence plug: a disposable device for patients with anorectal incontinence. Lancet 1991;338:295-.

    Article  PubMed  CAS  Google Scholar 

  39. Norton C, Kamm MA. Anal plug for faecal incontinence. Colorectal Dis 2001;3:323-.

    Article  PubMed  CAS  Google Scholar 

  40. Kim J, Shim MC, Choi BY, Ahn SH, Jang SH, Shin HJ. Clinical application of continent anal plug in bedridden patients with intractable diarrhea. Dis Colon Rectum 2001;44:1162-.

    Article  PubMed  CAS  Google Scholar 

  41. Deutekom M, Dobben A. Plugs for containing faecal incontinence. Cochrane Database Syst Rev 2005;3:CD005086.

    PubMed  Google Scholar 

  42. Christiansen J, Roed-Petersen K. Clinical assessment of the anal continence plug. Dis Colon Rectum 1993;36:740-

    Article  PubMed  CAS  Google Scholar 

  43. Sanchez MT, Barrientos FG, Arrojo VF, Vazquez Estevez JJ. The anal plug in the treatment of fecal incontinence in myelomeningocele patients: results of the first clinical trial. An Esp Pediatr 1999;51:489-2.

    Google Scholar 

  44. Cook TA, Mortensen NJ. Management of faecal incontinence following obstetric injury. Br J Surg 1998;85:293-

    Article  PubMed  CAS  Google Scholar 

  45. Ooi BS, Tjandra JJ, Tang CL, Dwyer P, Carey M. Anorectal physiological testing before and after a successful sphincter repair: a prospective study. Colorectal Dis 2000;2:220-.

    Article  Google Scholar 

  46. Pinta T, Kylanpaa-Back ML, Salmi T, Jarvinen HJ, Luukkonen P. Delayed sphincter repair for obstetric ruptures: analysis of failure. Colorectal Dis 2003;5:73-.

    Article  PubMed  CAS  Google Scholar 

  47. Tjandra JJ, Han WR, Goh J, Carey M, Dwyer P. Direct repair vs. overlapping sphincter repair: a randomized, controlled trial. Dis Colon Rectum 2003;46:937-2.

    Article  PubMed  CAS  Google Scholar 

  48. Tjandra JJ, Han W, Dwyer P, Carey M. Randomized trial of short stay vs. long stay after sphincter repair. Dis Colon Rectum 2000;43:A50.

    Article  Google Scholar 

  49. Parks AG, McPartlin JF. Later repair of injuries of the anal sphincter. Proc R Soc Med 1971;64:1187-.

    PubMed  CAS  Google Scholar 

  50. Malouf AJ, Norton, Engel AF, Nicholls RJ, Kamm MA. Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet 2000;355:260-.

    Article  PubMed  CAS  Google Scholar 

  51. Elton C, Stoodley BJ. Anterior anal sphincter repair: results in a district general hospital. Ann R Coll Surg Engl 2002;84:321-.

    Article  PubMed  Google Scholar 

  52. Engel AF, Kamm MA, Sultan AH, Bartram CI, Nicholls RJ. Anterior anal sphincter repair in patients with obstetric trauma. Br J Surg 1994;81:1231-.

    Article  PubMed  CAS  Google Scholar 

  53. Fleshman JW, Peters WR, Shemesh EI, Fry RD, Kodner IJ. Anal sphincter reconstruction: anterior overlapping muscle repair. Dis Colon Rectum 1991;34:739-3.

    Article  PubMed  CAS  Google Scholar 

  54. Jacobs PP, Scheuer M, Kuijpers JH, Vingerhoets MH. Obstetric fecal incontinence. Role of pelvic floor denervation and results of delayed sphincter repair. Dis Colon Rectum 1990;33:494-.

    Article  PubMed  CAS  Google Scholar 

  55. Norderval S, Oian P, Revhaug A, Vonen B. Anal incontinence after obstetric sphincter tears: outcome of anatomic primary repairs. Dis Colon Rectum 2005;48:1055-1.

    Article  PubMed  Google Scholar 

  56. Oliveira L, Pfeifer J, Wexner SD. Physiological and clinical outcome of anterior sphincteroplasty. Br J Surg 1996;83:502-.

    Article  PubMed  CAS  Google Scholar 

  57. Osterberg A, Edebol Eeg-Olofsson K, Graf W. Results of surgical treatment for faecal incontinence. Br J Surg 2000;87:1546-2.

    Article  PubMed  CAS  Google Scholar 

  58. Pinta T, Kylanpaa-Back ML, Salmi T, Jarvinen HJ, Luukkonen P. Delayed sphincter repair for obstetric ruptures: analysis of failure. Colorectal Dis 2003;5:73-

    Article  PubMed  CAS  Google Scholar 

  59. Sitzler PJ, Thompson JP. Overlap repair of damaged anal sphincter. A single surgeon’s series. Dis Colon Rectum 1996;39:1356-0.

    Article  PubMed  CAS  Google Scholar 

  60. Barisic GI, Krivokapic ZV, Markovic VA, Popovic MA. Outcome of overlapping anal sphincter repair after 3 months and after a mean of 80 months. Int J Colorectal Dis 2006;21:52-.

    Article  PubMed  Google Scholar 

  61. Bravo Gutierrez A, Madoff RD, Lowry AC, Parker SC, Buie WD, Baxter NN. Long-term results of anterior sphincteroplasty. Dis Colon Rectum 2004;47:727-1.

    Article  PubMed  Google Scholar 

  62. Londono-Schimmer EE, Garcia-Duperly R, Nicholls RJ, Ritchie JK, Hawley PR. Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five-year follow-up functional results. Int J Colorectal Dis 1994;9:110-.

    Article  PubMed  CAS  Google Scholar 

  63. Morren GL, Hallbook O, Nystrom PO, Baeten CG, Sjodahl R. Audit of anal-sphincter repair. Colorectal Dis 2001;3:17–22.

    Article  PubMed  CAS  Google Scholar 

  64. Rothbarth J, Bemelman WA, Meijerink WJ, Buyze-Westerweel ME, van Dijk JG, Delemarre JB. Long-term results of anterior anal sphincter repair for fecal incontinence due to obstetric injury. Dig Surg 2000;17:390-.

    Article  PubMed  CAS  Google Scholar 

  65. Zorcolo L, Covotta L, Bartolo DC. Outcome of anterior sphincter repair for obstetric injury: comparison of early and late results. Dis Colon Rectum 2005;48:524-1.

    Article  PubMed  Google Scholar 

  66. Halverson AL, Hull TL. Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 2002;45:345-.

    Article  PubMed  Google Scholar 

  67. Leroi AM, Kamm MA, Weber J, Denis P, Hawley PR. Internal anal sphincter repair. Int J Colorectal Dis 1997;12:243-.

    Article  PubMed  CAS  Google Scholar 

  68. Venkatesh KS, Ramanujam PS, Larson DM, Haywood MA. Anorectal complications of vaginal delivery. Dis Colon Rectum 1989;32:1039-1.

    Article  PubMed  CAS  Google Scholar 

  69. Nielsen MB, Hauge C, Rasmussen OO, Pedersen JF, Christiansen J. Anal endosonographic findings in the follow-up of primarily sutured sphincteric ruptures. Br J Surg 1992;79:104-.

    Article  PubMed  CAS  Google Scholar 

  70. Giordano P, Renzi A, Efron J, et al. Previous sphincter repair does not affect the outcome of repeat repair. Dis Colon Rectum 2002;45:635-0.

    Article  PubMed  Google Scholar 

  71. Pinedo G, Vaizey CJ, Nicholls RJ, Roach R, Halligan S, Kamm MA. Results of repeat anal sphincter repair. Br J Surg 1999;86:66-.

    Article  PubMed  CAS  Google Scholar 

  72. Vaizey CJ, Norton C, Thornton MJ, Nicholls RJ, Kamm MA. Long-term results of repeat anterior anal sphincter repair. Dis Colon Rectum 2004;47:858-3.

    Article  PubMed  Google Scholar 

  73. Richard C, Bernard D, Morgan S, Tasse D, Wassef R. Results of anal sphincteroplasty for post-traumatic incontinence: with or without colostomy. Ann Chir 1994;48:703-.

    PubMed  CAS  Google Scholar 

  74. Hasegawa H, Yoshioka K, Keighley MR. Randomized trial of fecal diversion for sphincter repair. Dis Colon Rectum 2000;43:961-.

    Article  PubMed  CAS  Google Scholar 

  75. Parks AG. Anorectal incontinence. Proc R Soc Med 1975;68:683-.

    Google Scholar 

  76. Abbas, SM, Bissett IP, Neill ME, et al. Long-term outcome of postanal repair in the treatment of faecal incontinence. ANZ J Surg 2005;75:783-.

    Article  PubMed  Google Scholar 

  77. Matsuoka H, Mavrantonis C, Wexner SD, Oliveira L, Gilliland R, Pikarsky A. Postanal repair for fecal incontinence: is it worthwhile? Dis Colon Rectum 2000;43:1561-.

    Article  PubMed  CAS  Google Scholar 

  78. Browning GG, Parks AG. Postanal repair for neuropathic faecal incontinence: correlation of clinical result and anal canal pressures. Br J Surg 1983;70:101-.

    Article  PubMed  CAS  Google Scholar 

  79. Yoshioka K, Keighley MR. Critical assessment of the quality of continence after postanal repair for fecal incontinence. Br J Surg 1989;76:1054-.

    Article  PubMed  CAS  Google Scholar 

  80. Athanasiadis S, Sanchez M, Kuprian A. Long-term follow-up of Parks posterior repair. An electromyographic, manometric and radiologic study of 31 patients. Langenbecks Arch Chir 1995;380:22–30.

    PubMed  CAS  Google Scholar 

  81. Briel JW, Schouten WR. Disappointing results of postanal repair in the treatment of fecal incontinence. Ned Tijdschr Geneeskd 1995;139:23-.

    PubMed  CAS  Google Scholar 

  82. Engel AF, van Baal SJ, Brummelkamp WH. Late results of postanal repair for idiopathic faecal incontinence. Eur J Surg 1994;160:637-0.

    PubMed  CAS  Google Scholar 

  83. Ferguson EF. Puborectalis sphincteroplasty for anal incontinence. South Med J 1984;77:423-.

    Article  PubMed  Google Scholar 

  84. Habr-Gama A, Alves PA, da Silva e Souza AH, et al. Treatment of faecal incontinence by post-anal repair. Coloproctology 1986;8:244-.

    Google Scholar 

  85. Jameson JS, Speakman CT, Darzi A, Chia YW, Henry MM. Audit of postanal repair in the treatment of fecal incontinence. Dis Colon Rectum 1994;37:369-2.

    Article  PubMed  CAS  Google Scholar 

  86. Orrom WJ, Miller R, Cornes H, Duthie G, Mortensen NJ, Bartolo DC. Comparison of anterior sphincteroplasty and postanal repair in the treatment of idiopathic fecal incontinence. Dis Colon Rectum 1991;34:305-0.

    Article  PubMed  CAS  Google Scholar 

  87. Rainey JB, Donaldson DR, Thompson JP. Postanal repair: which patients derive most benefits? J R Coll Surg Edinb 1990; 35: 101-.

    PubMed  CAS  Google Scholar 

  88. Rieger NA, Sarre RG, Saccone GT, Hunter A, Toouli J. Postanal repair for faecal incontinence: long-term follow-up. ANZ J Surg 1997;67:566-0.

    Article  CAS  Google Scholar 

  89. Scheuer M, Kuijpers HC, Jacobs PP. Postanal repair restores anatomy rather than function. Dis Colon Rectum 1989;32:960-.

    Article  PubMed  CAS  Google Scholar 

  90. Scott AN, Henry MM, Phillips RK. Clinical assessment and anorectal manometry before postanal repair: failure to predict outcome. Br J Surg 1990;77:628-.

    Article  PubMed  CAS  Google Scholar 

  91. Setti Carraro P, Kamm MA, Nicholls RJ. Long-term results of postanal repair for neurogenic faecal incontinence. Br J Surg 1994;81:140-.

    Article  PubMed  CAS  Google Scholar 

  92. Womack NR, Morrison JF, Williams NS. Prospective study of the effects of postanal repair in neurogenic faecal incontinence. Br J Surg 1988;75:48–52.

    Article  PubMed  CAS  Google Scholar 

  93. Laurberg S, Swash M, Henry MM. Effect of postanal repair on progress of neurogenic damage to the pelvic floor. Br J Surg 1990;77:519-2.

    Article  PubMed  CAS  Google Scholar 

  94. Snooks SJ, Swash M, Henry M. Electrophysiologic and manometric assessment of failed postanal repair for anorectal incontinence. Dis Colon Rectum 1984;27:733-

    Article  PubMed  CAS  Google Scholar 

  95. Bartolo DC, Roe AM, Locke-Edmunds JC. Flap-valve theory of anorectal continence. Br J Surg 1986;73:1012-.

    Article  Google Scholar 

  96. Miller R, Orrom WJ, Cornes H. Anterior sphincter placation and levatorplasty in the treatment of faecal incontinence. Br J Surg 1989;76:1058-0.

    Article  PubMed  CAS  Google Scholar 

  97. Baeten C, Spaans F, Fluks A. An implanted neuromuscular stimulator for fecal continence following previously implanted gracilis muscle: report of a case. Dis Colon Rectum 1988;31:134-.

    Article  PubMed  CAS  Google Scholar 

  98. Chapman AE, Geerdes B, Hewett P, et al. Systematic review of dynamic graciloplasty in the treatment of faecal incontinence. Br J Surg 2002;89:138-3.

    PubMed  CAS  Google Scholar 

  99. Ho KS, Seow-Choen F. Dynamic graciloplasty for total anorectal reconstruction after abdominoperineal resection for rectal tumour. Int J Colorectal Dis 2005;20:38–41.

    Article  Google Scholar 

  100. Rosen HR, Urbarz C, Novi G, Zoch G, Schiessel R. Long-term results of modified graciloplasty for sphincter replacement after rectal excision. Colorectal Dis 2002;4:266-.

    Article  PubMed  Google Scholar 

  101. Baeten CG, Geerdes BP, Adang EM, et al. Anal dynamic graciloplasty in the treatment of intractable fecal incontinence. N Engl J Med 1995;332:1600-.

    Article  PubMed  CAS  Google Scholar 

  102. Baeten CG, Bailey HR, Bakka A, et al. Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic graciloplasty therapy study group. Dis Colon Rectum 2000;43:743-1.

    Article  PubMed  CAS  Google Scholar 

  103. Bresler L, Reibel N, Brunard L, et al. Dynamic graciloplasty in the treatment of severe fecal incontinence. French multicentric retrospective study. Ann Chir 2002;127:520-.

    Article  PubMed  CAS  Google Scholar 

  104. Cavina E, Seccia M, Banti P, Zocco G. Anorectal reconstruction after abdominoperineal resection. Experience with double-wrap graciloplasty supported by low-frequency electrostimulation. Dis Colon Rectum 1998;41:1010-.

    Article  PubMed  CAS  Google Scholar 

  105. Geerdes BP, Zoetmulder FA, Heineman E, Vos EJ, Rongen MJ, Baeten CG. Total anorectal reconstruction with a double dynamic graciloplasty after abdominoperineal reconstruction for low rectal cancer. Dis Colon Rectum 1997;40:698–705.

    Article  PubMed  CAS  Google Scholar 

  106. Koch SM, Uluda O, Rongen M, Baeten CG, van Gemert W. Dynamic graciloplasty in patients born with an anorectal malformation. Dis Colon Rectum 2004;47:1711-.

    Article  PubMed  Google Scholar 

  107. Mander BJ, Abercrombie JF, George BD, Williams NS. The electrically stimulated gracilis neosphincter incorporated as part of total anorectal reconstruction after abdominoperineal excision of the rectum. Ann Surg 1996;224:702-1.

    Article  PubMed  CAS  Google Scholar 

  108. Mander BJ, Wexner SD, Williams NS, et al. Preliminary results of a multicenter trial of the electrically stimulated gracilis neoanal sphincter. Br J Surg 1999;86:1543-.

    Article  PubMed  CAS  Google Scholar 

  109. Penninckx F. Belgian experience with dynamic graciloplasty for faecal incontinence. Br J Surg 2004;91:872-.

    Article  PubMed  CAS  Google Scholar 

  110. Rongen MJ, Uludag O, El Naggar K, Geerdes BP, Konsten J, Baeten CG. Long-term follow-up of dynamic graciloplasty for fecal incontinence. Dis Colon Rectum 2003;46:716-1.

    Article  PubMed  Google Scholar 

  111. Rouanet P, Senesse P, Bouamrirene D, et al. Anal sphincter reconstruction by dynamic graciloplasty after abdominoperineal resection for cancer. Dis Colon Rectum 1999;42:451-.

    Article  PubMed  CAS  Google Scholar 

  112. Rullier E, Zerbib F, Laurent C, Caudry M, Saric J. Morbidity and functional outcome after double dynamic graciloplasty for anorectal reconstruction. Br J Surg 87 2000;:909–913.

    Article  PubMed  CAS  Google Scholar 

  113. Thornton MJ, Kennedy ML, Lubowski DZ, King DW. Long-term follow-up of dynamic graciloplasty for faecal incontinence. Colorectal Dis 2004;6:470-.

    Article  PubMed  CAS  Google Scholar 

  114. Wexner SD, Baeten C, Bailey R, et al. Long-term efficacy of dynamic graciloplasty for fecal incontinence. Dis Colon Rectum 2002;45:809-8.

    Article  PubMed  Google Scholar 

  115. Williams NS, Patel J, George BD, Hallan RI, Watkins ES. Development of an electrically stimulated neoanal sphincter. Lancet 1991;338:1166-.

    Article  PubMed  CAS  Google Scholar 

  116. Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology 1973;1:252-.

    Article  PubMed  CAS  Google Scholar 

  117. Person B, Wexner SD. Advances in the surgical treatment of fecal incontinence. Surg Innov 2004;12:7–21.

    Article  Google Scholar 

  118. Christiansen J, Lorentzen M. Implantation of artificial sphincter for anal incontinence. Lancet 1987;2:244-.

    Article  PubMed  CAS  Google Scholar 

  119. Mundy L, Merlin TL, Maddern GJ, Hiller JE. Systematic review of safety and effectiveness of an artificial bowel sphincter for faecal incontinence. Br J Surg 2004;91:665-2.

    Article  PubMed  CAS  Google Scholar 

  120. Altomare DF, Dodi G, La Torre F, Romano G, Melega E, Rinaldi M. Multicentre retrospective analysis of the outcome of artificial anal sphincter implantation for severe faecal incontinence. Br J Surg 2001;88:1481-.

    Article  PubMed  CAS  Google Scholar 

  121. Devesa JM, Rey A, Hervas PL, et al. Artificial anal sphincter: complications and functional results of a large personal series. Dis Colon Rectum 2002;45:1154-3.

    Article  PubMed  Google Scholar 

  122. Lehur PA, Glemain P, Bruley des Varannes S, Buzelin JM, Leborgne J. Outcome of patients with an implanted artificial anal sphincter for severe faecal incontinence. A single institution report. Int J Colorectal Dis 1998;13:88–92.

    Article  PubMed  CAS  Google Scholar 

  123. O’Brien PE, Dixon JB, Skinner S, Laurie C, Khera A, Fonda D. A prospective, randomized, controlled clinical trial of placement of the artificial bowel sphincter (Acticon neosphincter) for the control of fecal incontinence. Dis Colon Rectum 2004;47:1852-0.

    Article  PubMed  Google Scholar 

  124. Ortiz H, Armendariz P, DeMiguel M, Ruiz MD, Alos R, Roig JV. Complications and functional outcome following artificial anal sphincter implantation. Br J Surg 2002;89:877-1.

    Article  PubMed  CAS  Google Scholar 

  125. Vaizey CJ, Kamm MA, Gold DM, Bartram CI, Halligan S, Nicholls RJ. Clinical, physiological, and radiological study of a new purpose-designed artificial bowel sphincter. Lancet 1998;352:105-.

    PubMed  CAS  Google Scholar 

  126. Casal E, San Ildefonso A, Carracedo R, Facal C, Sanchez JA. Artificial bowel sphincter in severe anal incontinence. Colorectal Dis 2004;6:180-.

    Article  PubMed  CAS  Google Scholar 

  127. Dodi G, Melega E, Masin A, Infantino A, Cavallari F, Lise M. Artificial bowel sphincter (ABS) for severe faecal incontinence: a clinical and manometric study. Colorectal Dis 2000;2:207-1.

    Article  Google Scholar 

  128. Lehur PA, Roig JV, Duinslaeger M. Artificial anal sphincter: prospective clinical and manometric evaluation. Dis Colon Rectum 2000;43:1100-.

    Article  PubMed  CAS  Google Scholar 

  129. Lehur PA, Zerbib F, Neunlist M, Glemain P, Bruley des Varannes S. Comparison of quality of life and anorectal function after artificial sphincter implantation. Dis Colon Rectum 2002;45:508-3.

    Article  PubMed  Google Scholar 

  130. Wong WD, Congliosi SM, Spencer MP, et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. Dis Colon Rectum 2002;45:1139-3.

    Article  PubMed  Google Scholar 

  131. Christiansen J, Rasmussen OO, Lindorff-Larsen K. Long-term results of artificial anal sphincter implantation for severe anal incontinence. Ann Surg 1999;230:45-.

    Article  PubMed  CAS  Google Scholar 

  132. Parker SC, Spencer MP, Madoff RD, Jensen LL, Wong WD. Artificial bowel sphincter long-term experience at a single institution. Dis Colon Rectum 2003;46:722-.

    Article  PubMed  Google Scholar 

  133. Frankl-Hochwart LV, Zuckerkandl O. Die nervösen Erkrankungen der Harnblase. In: Nothnagel HA, Holder A, eds. Spezielle pathologie und therapie. Volume 109. Vienna, 1906.

  134. Matzel K, Stadelmaier M, Hohenfellner FP. Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet 1995;346:1124-.

    Article  PubMed  CAS  Google Scholar 

  135. Tjandra JJ, Lim JF, Matzel K. Sacral nerve stimulation: an emerging treatment for faecal incontinence. ANZ J Surg 2004;74:1098-06.

    Article  PubMed  Google Scholar 

  136. Matzel K, Schmidt RA, Tanagho EA. Neuroanatomy of the striated anal continence mechanism: implications for use of neurostimulation. Dis Colon Rectum 1990;33:666-3.

    Article  PubMed  CAS  Google Scholar 

  137. Schraffordt SE, Tjandra JJ, Eizenberg N, Dwyer PL. The anatomy of the pudendal nerve and its terminal branches: a cadaver study. ANZ J Surg 2004;74:23-.

    Article  PubMed  Google Scholar 

  138. Tjandra JJ, Sharma BR, McKirdy H, Lowndes RH, Mansel RE. Anorectal physiological testing in defaecatory disorders: a prospective study. ANZ J Surg 1994;64:322-

    Article  CAS  Google Scholar 

  139. Tanagho EA. Concepts of neuromodulation. Neurourol Urodyn 1993;12:487-.

    Article  PubMed  CAS  Google Scholar 

  140. Kenefick NJ, Emmanuel A, Nicholls RJ, Kamm MA. Effect of sacral nerve stimulation on autonomic nerve function. Br J Surg 2003;90:1256-0.

    Article  PubMed  CAS  Google Scholar 

  141. Ganio E, Masin A, Ratto C, et al. Short-term sacral nerve stimulation for functional anorectal and urinary disturbances: results in 40 patients. Evaluation of a new option for anorectal functional disorders. Dis Colon Rectum 2001;44:1261-.

    Article  PubMed  CAS  Google Scholar 

  142. Kenefick NJ, Vaizey CJ, Nicholls RJ, Cohen R, Kamm MA. Sacral nerve stimulation for faecal incontinence due to systemic sclerosis. Gut 2002;51:881-.

    Article  PubMed  CAS  Google Scholar 

  143. Matzel KE, Stadelmaier U, Hohenfellner M, Hohenberger W. Chronic sacral spinal nerve stimulation for fecal incontinence: long-term results with foramen and cuff electrodes. Dis Colon Rectum 2001;44:59–66.

    Article  PubMed  CAS  Google Scholar 

  144. Altomare DF, Rinaldi M, Petrolino M, et al. Permanent sacral nerve modulation for fecal incontinence and associated urinary disturbances. Int J Colorectal Dis 2004;19:203-.

    Article  PubMed  Google Scholar 

  145. Ganio E, Ratto C, Masin A, et al. Neuromodulation for fecal incontinence: outcome in 16 patients with definitive implant: the initial Italian sacral neurostimulation group (GINS) experience. Dis Colon Rectum 2001;44:965-0.

    Article  PubMed  CAS  Google Scholar 

  146. Jarrett ME, Varma JS, Duthie GS, Nicholls RJ, Kamm MA. Sacral nerve stimulation for faecal incontinence in the UK. Br J Surg 2004;91:755-1.

    Article  PubMed  CAS  Google Scholar 

  147. Kenefick NJ, Vaizey CJ, Cohen RC, Nicholls RJ, Kamm MA. Medium-term results of permanent sacral nerve stimulation for faecal incontinence. Br J Surg 2002;89:896–901.

    Article  PubMed  CAS  Google Scholar 

  148. Leroi AM, Parc Y, Lehur PA, et al. Efficacy of sacral nerve stimulation for fecal incontinence: results of a multicenter double-blind crossover study. Ann Surg 2005;242:662-.

    Article  PubMed  Google Scholar 

  149. Malouf AJ, Vaizey CJ, Nicholls RJ, Kamm MA. Permanent sacral nerve stimulation for fecal incontinence. Ann Surg 2000;232:143-.

    Article  PubMed  CAS  Google Scholar 

  150. Matzel KE, Kamm MA, Stosser M, et al. Sacral nerve stimulation for faecal incontinence: multicentre study. Lancet 2004;363:1270-.

    Article  PubMed  Google Scholar 

  151. Rasmussen OO, Buntzen S, Sorensen M, Laurberg S, Christiansen J. Sacral nerve stimulation in fecal incontinence. Dis Colon Rectum 2004;47:1158-3.

    Article  PubMed  Google Scholar 

  152. Ratto C, Grillo E, Parello A, Petrolino M, Costamagna G, Doglietto GB. Sacral neuromodulation in treatment of fecal incontinence following anterior resection and chemoradiation for rectal cancer. Dis Colon Rectum 2005;48:1027-6

    Article  PubMed  Google Scholar 

  153. Ripetti V, Caputo D, Ausania F, Esposito E, Bruni R, Arullani A. Sacral nerve neuromodulation improves physical, psychological and social quality of life in patients with fecal incontinence. Tech Coloproctol 2002;6:147-2.

    Article  PubMed  CAS  Google Scholar 

  154. Rosen HR, Urbarz C, Holzer B, Novi G, Schiessel R. Sacral nerve stimulation as a treatment for fecal incontinence. Gastroenterology 2001;121:536-1.

    Article  PubMed  CAS  Google Scholar 

  155. Tjandra JJ, Green C, Lim JF. Sacral neuromodulation in patients with fecal incontinence: a randomized controlled study on efficacy and quality of life. Dis Colon Rectum 2005;48:622.

    Google Scholar 

  156. Uludag O, Koch SM, van Gemert WG, Dejong CH, Baeten CG. Sacral neuromodulation in patients with fecal incontinence: a single-center study. Dis Colon Rectum 2004;47:1350-.

    Article  PubMed  Google Scholar 

  157. Shafik A. Polytetrafluroethylene injection for the treatment of partial fecal incontinence. Int Surg 1993;78:159-1.

    PubMed  CAS  Google Scholar 

  158. Shafik A. Perianal injection of autologous fat for treatment of sphincteric incontinence. Dis Colon Rectum 1995;38:583-.

    Article  PubMed  CAS  Google Scholar 

  159. Bernardi C, Favetta U, Pescatory M. Autologous fat injection for treatment of fecal incontinence: manometric and echographic assessment. Plast Reconstr Surg 1998;102:1626-.

    Article  PubMed  CAS  Google Scholar 

  160. Vaizey CJ, Kamm MA. Injectable bulking agents for treating faecal incontinence. Br J Surg 2005;92:521-.

    Article  PubMed  CAS  Google Scholar 

  161. Sweat SD, Lightener DJ. Complications of sterile abscess formation and pulmonary embolism following periurethral bulking agents. J Urol 1999;161:93-.

    Article  PubMed  CAS  Google Scholar 

  162. Yoon SS, Chang DI, Chung KC. Acute fatal stroke immediately following autologous fat injection into the face. Neurology 2003;61:1151-.

    PubMed  Google Scholar 

  163. Currie I, Drutz HP, Deck J, Oxorn D. Adipose tissue and lipid droplet embolism following periurethral injection of autologous fat: case report and review of the literature. Int Urogynecol J Pelvic Floor Dysfunct 1997;8:377-0

    Article  PubMed  CAS  Google Scholar 

  164. Kumar D, Benson MJ, Bland JE. Glutaraldehyde cross-linked collagen in the treatment of faecal incontinence. Be J Surg 1998;85:978-.

    Article  PubMed  CAS  Google Scholar 

  165. Malouf AJ, Vaizey CJ, Norton CS, Kamm MA. Internal anal sphincter augmentation for fecal incontinence using injectable silicone biomaterial. Dis Colon Rectum 2001;44:595–600.

    Article  PubMed  CAS  Google Scholar 

  166. Kenefick NJ, Vaizey CJ, Malouf AJ, Norton CS, Marshall M, Kamm MA. Injectable silicone biomaterial for faecal incontinence due to internal anal sphincter dysfunction. Gut 2002;51:225-.

    Article  PubMed  CAS  Google Scholar 

  167. Tjandra JJ, Lim JF, Hiscock R, Rajendra P. Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction is effective. Dis Colon Rectum 2004;47:2138-6.

    Article  PubMed  CAS  Google Scholar 

  168. Tjandra JJ, Tan J, Lim JF, Murray-Green C. Long-term results of injectable silicone biomaterial for passive fecal incontinence: a randomized trial [abstract]. Dis Colon Rectum 2006;49:730–731.

    Article  Google Scholar 

  169. Chan MK, Tjandra JJ. Injectable silicone biomaterial (PTQ- to treat fecal incontinence after hemorrhoidectomy. Dis Colon Rectum 2006;49:433-.

    Article  PubMed  Google Scholar 

  170. Weiss EG, Efron JE, Nogueras JJ, Wexner SD. Submucosal injection of carbon coated beads is a successful and safe office based treatment for fecal incontinence. Dis Colon Rectum 2002;45:A46-.

    Google Scholar 

  171. Davis K, Kumar D, Poloniecki J. Preliminary evaluation of an injectable anal sphincter bulking agent (Durasphere) in the management of faecal incontinence. Aliment Pharmacol Ther 2003;18:237-3.

    Article  PubMed  CAS  Google Scholar 

  172. Gustavson KH. On the chemistry of collagen. Fed Proc 1964;23:613-.

    PubMed  CAS  Google Scholar 

  173. Takahashi T, Garcia-Osogobio S, Valdovinos MA, et al. Radio-frequency energy delivery to the anal canal for the treatment of fecal incontinence. Dis Colon Rectum 2002;45:915-2.

    Article  PubMed  Google Scholar 

  174. Takahashi T, Garcia-Osogobio S, Valdovinos MA, Belmonte C, Barreto C, Velasco L. Extended two-year results of radio-frequency energy delivery for the treatment of fecal incontinence (the Secca procedure). Dis Colon Recum 2003;46:711-.

    Article  Google Scholar 

  175. Efron JE, Corman ML, Fleshman J, et al. Safety and effectiveness of temperature-controlled radio-frequency energy delivery to the anal canal (Secca procedure) for the treatment of fecal incontinence. Dis Colon Rectum 2003;46:1606-6.

    Article  PubMed  Google Scholar 

  176. Malone PS, Ransley PG, Kiely EM. Preliminary report: the antegrade continence enema. Lancet 1990;336:1217-.

    Article  PubMed  CAS  Google Scholar 

  177. Krogh K, Laurberg S. Malone antegrade continence enema for faecal incontinence and constipation in adults. Br J Surg 1998;85:974-.

    Article  PubMed  CAS  Google Scholar 

  178. Griffiths DM, Malone PS. The Malone antegrade continence enema. J Pediatr Surg 1995;30:68–71.

    Article  PubMed  CAS  Google Scholar 

  179. Squire R, Kiely EM, Carr B, Ransley PG, Duffy PG. The clinical application of the Malone antegrade colonic enema. J Pediatr Surg 1993;28:1012-.

    Article  PubMed  CAS  Google Scholar 

  180. Koyle MA, Kaji DM, Duque M, Wild J, Galansky SH. The Malone antegrade continence enema for neurogenic and structural faecal incontinence and constipation. J Urol 1995;154:759-1.

    Article  PubMed  CAS  Google Scholar 

  181. Wheeler RA, Malone PS. Use of the appendix in reconstructive surgery: a case against appendicectomy. Br J Surg 1994;81:1490-.

    Article  Google Scholar 

  182. Yang CC, Stiens SA. Antegrade continence enema for the treatment of neurogenic constipation and fecal incontinence after spinal cord injury. Arch Phys Med Rehabil 2000;81:683-.

    Article  PubMed  CAS  Google Scholar 

  183. Churchill BM, De Ugarte DA, Atkinson JB. Left-colon antegrade continence enema (LACE) procedure for fecal incontinence. J Pediatr Surg 2003;38:1778-0

    Article  PubMed  Google Scholar 

  184. Herndon CD, Rink RC, Cain MP, et al. In situ Malone antegrade continence enema in 127 patients: a 6-year experience. J Urol 2004;172:1689-1.

    Article  PubMed  Google Scholar 

  185. Robertson RW, Lynch AC, Beasley SW, Morreau PN. Early experience with the laparoscopic ace procedure. ANZ J Surg 1999;69:308-0.

    Article  CAS  Google Scholar 

  186. Stone JM, Wolfe VA, Nino-Murcia M, Perkash I. Colostomy as treatment for complications of spinal cord injury. Arch Phys Med Rehabil 1990;71:514-.

    PubMed  CAS  Google Scholar 

  187. Saltzstein RJ, Romano J. The efficacy of colostomy as a bowel management alternative in selected spinal cord injury patients. J Am Paraplegia Soc 1990;13:9–13

    PubMed  CAS  Google Scholar 

  188. Vaizey CJ, Kamm MA. Nicholls RJ. Recent advances in the surgical treatment of faecal incontinence. Br J Surg 1998;85:596–603.

    Article  PubMed  CAS  Google Scholar 

  189. Norton C, Burch J, Kamm MA. Patients-views of a colostomy for fecal incontinence. Dis Colon Rectum 2005;48:1062-.

    Article  PubMed  Google Scholar 

  190. Stone JM, Wolfe VA, Nino-Murcia M, Perkash I. Colostomy as treatment for complications of spinal cord injury. Arch Phys Med Rehabil 1990;71:514-.

    PubMed  CAS  Google Scholar 

  191. Senapati A, Phillips RK. The trephine colostomy: a permanent left iliac fossa end colostomy without recourse to laparotomy. Ann R Coll Surg Engl 1991;73:305-.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Royal Melbourne Hospital and Epworth Colorectal Centre, Melbourne, Australia

    Jane J. Y. Tan M.B.B.S., M.R.C.S., Miranda Chan M.B.B.S., F.R.A.C.S & Joe J. Tjandra M.D., F.R.A.C.S.

  2. Royal Melbourne Hospital, Suites 15 & 16, Private Medical Centre, Royal Parade, Parkville, Victoria, 3050, Australia

    Jane J. Y. Tan M.B.B.S., M.R.C.S.

Authors
  1. Jane J. Y. Tan M.B.B.S., M.R.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miranda Chan M.B.B.S., F.R.A.C.S
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joe J. Tjandra M.D., F.R.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jane J. Y. Tan M.B.B.S., M.R.C.S..

Additional information

aDeceased.

About this article

Cite this article

Tan, J.J.Y., Chan, M. & Tjandra, J.J. Evolving Therapy for Fecal Incontinence. Dis Colon Rectum 50, 1950–1967 (2007). https://doi.org/10.1007/s10350-007-9009-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-007-9009-2

Key words

Search

Navigation