Abstract
PURPOSE: The aim of this study was to evaluate the results of treatment of partial fecal incontinence with perianal injection of autologous fat. METHODS: The study comprised 14 patients with partial fecal incontinence (9 women and 5 men). Ages ranged from 38 to 62 years. Fifty to 60 ml of fat were harvested from the abdominal wall and injected submucosally into the rectal neck at 3 and 9 o'clock positions. Mean follow-up was 18.6 months. RESULTS: All patients were continent during the first two to three postinjection months. At the sixth month, patients were divided into three scores. Score 1 (complete continence) comprised three patients who are now continent for 9, 11, and 14 months postinjection, with normalization of their rectal neck pressure. Seven patients with Score 2 were incontinent to flatus and were reinjected; they are now continent (Score 1) for a mean of 13.8 months and have normal rectal neck pressure. Four patients had Score 3 (no improvement), of whom two became continent after the second injection and two after the third. They are now continent (Score 1) 6 to 16 months postinjection. Factors that contributed to failure comprised injection of unwashed fat or wrong positioning of the needle. There was no fat migration or embolism. CONCLUSION: Perianal fat injection is effective in treatment of partial fecal incontinence. The technique is simple, easy, cost-effective, and performed on an outpatient basis.
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References
Shafik A, Helmi AA, Abdel Moneim R, Farag A. Uninhibited rectal detrusor syndrome: report of 3 cases. Pract Gastroenterol (in press).
Shafik A. Uninhibited sphincter relaxation syndrome: a new syndrome with report of 4 cases. J Clin Gastroenterol 1992;15:29–32.
Parks AG, Swash M, Urich M. Sphincter denervation of anorectal incontinence and rectal prolapse. Gut 1977;18:656–65.
Neill ME, Parks AG, Swash M. Physiological studies of the anal sphincter musculature in fecal incontinence and rectal prolapse. Br J Surg 1981;68:531–6.
Duthie HL. Progress report: anal continence. Gut 1971;12:844–52.
Parks AG. Anorectal incontinence. J R Soc Med 1975;68:681–90.
Swash M. The neuropathy of idiopathic fecal incontinence. In: Smith WT, Cavanagh JB, eds. Recent advances in neuropathy. Edinburgh: Churchill Livingstone, 1982:242–71.
Caldwell KP. The electric control of sphincter incompetence. Lancet 1963;2:174–5.
Hopkinson BR, Lightwood R. Electrical treatment of anal incontinence. Lancet 1966;1:344–51.
Cerullo MA, Nikoomanesh P, Schuster MM. Progress in biofeedback conditioning of fecal incontinence. Gastroenterology 1979;76:742–6.
Womack NR, Morrison JE, Williams NS. Prospective study of the effects of postanal repair in neurogenic fecal incontinence. Br J Surg 1988;75:48–52.
Williams NS, Patel J, George BD, Hallan RI, Watkins ES. Development of electrically stimulated neoanal sphincter. Lancet 1991;338:1166–9.
Shafik A. Polytetrafluoroethylene injection for the treatment of partial fecal incontinence. Int Surg 1993;78:159–61.
Shafik A. Detrusor-sphincter dyssynergia syndrome: a new syndrome and its treatment by external sphincter myotomy. Eur Surg Res 1990;22:243–8.
Chajcher A, Benzaquen I. Fat-grafting injection for soft tissue augmentation. Plast Reconstr Surg 1989;84:921–5.
Gasperoni C, Salgarello M, Emiliozzi P, Gargani G. Subdermal liposuction. Aesthetic Plast Surg 1990;14:137–9.
Ellenbogen R. Free autogenous pearl fat grafts in the face—a preliminary report of a rediscovered technique. Ann Plast Surg 1986;16:179–82.
Horl HW, Feller AM, Biemer T. Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 1991;26:248–51.
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Shafik, A. Perianal injection of autologous fat for treatment of sphincteric incontinence. Dis Colon Rectum 38, 583–587 (1995). https://doi.org/10.1007/BF02054115
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DOI: https://doi.org/10.1007/BF02054115