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Current Assessment and Management of Fecal Incontinence

  • Female Stress Incontinence and Prolapse (R Dmochowski, Section Editor)
  • Published:
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Abstract

Fecal incontinence (FI) is a common condition, with as many as 9.5 % of women age ≥45 experiencing at least one episode per month. The past several years have brought forth many new minimally invasive therapeutic options for patients with this condition. Unfortunately, awareness of these options by both patients and medical providers remains low. This article reviews the current literature regarding the evaluation and management of fecal incontinence, with particular attention to novel therapeutic techniques.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Whitehead WE, Borrud L, Goode PS, et al. Fecal incontinence in US adults: epidemiology and risk factors. Gastroenterology. 2009;137:512–7.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Brown HW, Wexner SD, Segall MM, et al. Accidental bowel leakage in the mature women’s health study: prevalence and predictors. Int Clin Pract. 2012;66(11):1101–8. This is a large survey of >6,000 female patients over age 45 with an 86% response rate. This is some of the strongest available data regarding the prevalence of fecal incontinence in our society.

    Article  CAS  Google Scholar 

  3. Brown HW, Wexner SD, Segall MM, et al. Quality of life in women with accidental bowel leakage. Int Clin Pract. 2012;66(11):1109–16.

    Article  CAS  Google Scholar 

  4. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36:77–97.

    Article  CAS  PubMed  Google Scholar 

  5. Sangwan YP, Collar JA, Barrett RC, et al. Unilateral pudendal neuropathy. Impact on outcomes of anal sphincter repair. Dis Colon Rectum. 1996;39(6):686–9.

    Article  CAS  PubMed  Google Scholar 

  6. Deen KI, Kumar D, Williams JG, et al. Anal sphincter defects. Correlation between endoanal ultrasound and surgery. Ann Surg. 1993;218(2):201–5.

    Article  CAS  PubMed  Google Scholar 

  7. Oberwalder M, Thaler K, Baig MK, et al. Anal ultrasound and endosonographic measurement of perineal body thickness: a new evaluation for fecal incontinence in females. Surg Endosc. 2004;18(4):650–4.

    Article  CAS  PubMed  Google Scholar 

  8. Heymen S, Scarlett Y, Jones K, et al. Randomized controlled trial shows biofeedback to be superior to pelvic floor exercises for fecal incontinence. Dis Colon Rectum. 2009;52(10):1730–7.

    Article  PubMed  Google Scholar 

  9. El-Gazzaz G, Zutshi M, Hannaway C, Gurland B, Hull T. Overlapping sphincter repair: does age matter? Dis Colon Rectum. 2012;55(3):256–61. This article examines the controversial topic over whether to offer sphincter repair to older women.

    Article  CAS  PubMed  Google Scholar 

  10. Glasgow SC, Lowry AC. Long term outcomes of anal sphincter repair for fecal incontinence: a systematic review. Dis Colon Rectum. 2012;55(4):482–90. This article provides an excellent review of outcomes of sphincter repair over time and strongly reaffirms the concept that improvements in continence are not durable over time.

    Article  PubMed  Google Scholar 

  11. Hull T, Giese C, Wexner S, Mellgren A, et al. Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum. 2013;56:234–45. This is a 5-year update of the US multi center trial of neuromodulation. Key findings were excellent long-term outcomes, however, 35% of patients required revision of the device over time.

    Article  PubMed  Google Scholar 

  12. Tjandra JJ, Chan MK, Yeh CH, et al. Sacral nerve stimulation is more effective than optimal medical therapy for severe fecal incontinence: a randomized, controlled study. Dis Colon Rectum. 2008;51(5):494–502.

    Article  PubMed  Google Scholar 

  13. Graf W, Mellgren A, Matzel K, et al. Efficacy of a dextronamer in stabilized hyaluronic acid for treatment of faecal incontinence: a randomized, sham-controlled trial. Lancet. 2011;377:997–1003. This is the only currently published study using the Solesta procedure for fecal incontinence.

    Article  CAS  PubMed  Google Scholar 

  14. Christiansen J, Lorentzen M. Implantation of artificial sphincter for anal incontinence. Lancet. 1987;1:244–5.

    Article  Google Scholar 

  15. 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(9):1139–53.

    Article  PubMed  Google Scholar 

  16. Hong KD, Dasilva G, Kalaskar SN, et al. Long-term outcomes of artificial bowel sphincter for fecal incontinence: a systematic review and meta-analysis. J Am Coll Surg. 2013;217(4):718–25. This is a complete literature review detailing the clinical success and device related complications associated with the artificial bowel sphincter device.

    Article  PubMed  Google Scholar 

  17. Takahashi T, Morales M, Garcia-Osogobio S, et al. Secca procedure for the treatment of fecal incontinence: results of five-year follow-up. Dis Colon Rectum. 2008;51:355–9.

    Article  Google Scholar 

  18. Lehur PA, McNevin S, Buntzen S, et al. Magnetic anal sphincter augmentation for the treatment of fecal incontinence: a preliminary report from a feasibility study. Dis Colon Rectum. 2010;53:1604–10.

    Article  PubMed  Google Scholar 

  19. Topas sling: http://clinicaltrials.gov/ct2/show/NCT01090739

  20. Hotouras A, Thaha MA, Allison ME, et al. Percutaneous tibial nerve stimulation (PTNS) in females with faecal incontinence: the impact of sphincter morphology and rectal sensation on the clinical outcome. Int J Colorectal Dis. 2012;27(7):927–30. doi:10.1007/s00384-011-1405-3.

    Article  CAS  PubMed  Google Scholar 

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Compliance with Ethics Guidelines

Conflict of Interest

Ian M. Paquette has served as a consultant on a medical advisory board for Medtronic and has received honoraria from Medtronic and Salix.

Mickey Karram has served as a consultant on speakers bureaus for Astellas, American Medical Systems, and Medtronic and has a financial interest in Emedsco.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA

    Ian M. Paquette

  2. The Christ Hospital, University of Cincinnati, Cincinnati, USA

    Ian M. Paquette

  3. The Christ Hospital Center for Pelvic Floor Disorders, 2123 Auburn Ave. Suite 322, Cincinnati, OH, 45219, USA

    Ian M. Paquette & Mickey Karram

Authors
  1. Ian M. Paquette
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  2. Mickey Karram
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Correspondence to Ian M. Paquette.

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Paquette, I.M., Karram, M. Current Assessment and Management of Fecal Incontinence. Curr Bladder Dysfunct Rep 9, 6–12 (2014). https://doi.org/10.1007/s11884-013-0223-6

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  • DOI: https://doi.org/10.1007/s11884-013-0223-6

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