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Technique of the transobturator puborectal sling in fecal incontinence

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Abstract

Background

The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years.

Methods

Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results.

Results

The median CCIS was significantly improved at 12 months (18.5 [15–20] vs 7.5 [4–20] in postoperative assessment; p = 0.037). The median FIQL was improved at 12 months (6.05 [5.6–7] vs 10.2 [5.6–12.5]; p = 0.0542). No adverse event was recorded except the distension of the device in one patient. Finally, at 5 years, 3 patients were improved, 1 had recurrence of FI symptoms (at 24 months) and 2 had no change.

Conclusion

This technique is a minimally invasive surgical treatment and constitutes a new therapeutic option for FI in case of failure of conventional treatment.

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Author notes

    Authors and Affiliations

    1. Service des Maladies de l’Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, 2 rue Henri le Guillou, 35033, Rennes, France

      C. Brochard & L. Siproudhis

    2. Services d’Explorations Fonctionnelles Digestives, CHU Pontchaillou, Université de Rennes 1, Rennes, France

      C. Brochard

    3. Service de Colo-proctologie, Clinique des Cèdres, Cornebarrieu, France

      M. Queralto & P. Cabarrot

    4. Chirurgie Digestive, CHU Purpan, Université Paul Sabatier, Toulouse, France

      G. Portier

    Authors
    1. C. Brochard
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    2. M. Queralto
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    3. P. Cabarrot
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    4. L. Siproudhis
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    5. G. Portier
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    Corresponding author

    Correspondence to C. Brochard.

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    Conflict of interest

    The autors have no conflict of interest in the context of the subject of this article.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individuals participants included in the study. Additional informed consent was obtained from all individual patients for whom identifying information is included in this article.

    Additional information

    Charlène Brochard and Michel Queralto have contributed equally to this work

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    Brochard, C., Queralto, M., Cabarrot, P. et al. Technique of the transobturator puborectal sling in fecal incontinence. Tech Coloproctol 21, 315–318 (2017). https://doi.org/10.1007/s10151-017-1609-9

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    • DOI: https://doi.org/10.1007/s10151-017-1609-9

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