Abstract
Introduction Severe fecal incontinence describes a condition of complete loss of control over fundamental physiological functions and loss of abilities to fulfil psychosocial functions by the patients. The last-step procedure, that is, to restore hope for improvement of biopsychosocial functioning and quality of life determined by the patient's health status is implantation of an artificial anal sphincter. Objective The study was a comparative analysis of the effect of the employed surgical procedure upon the degree of defecation control and quality of life indices in its behavioral, mental, and social aspects prior to and 3, 6, and 12 months postoperatively. The analysis also included the effect of the patient's individual style of coping with stress and the functional outcome of the procedure. Material and Methods The study included a group of 12 patients: 6 females and 6 males, aged from 36 to 60 years of life. The tools consisted of scoring systems that measured symptom intensity (FISI and Jorge and Wexner scale). In assessing the psychosocial functioning, the authors employed the Fecal Incontinence Quality of Life Scale (by Rockwood). The individual mode of coping with the disease was evaluated by using the CISS scale by Endler and Parker. Conclusions The analysis of results demonstrated that the procedure of implanting an artificial anal sphincter affected the “continence” (up to 50–60% postoperatively) and led to improvement in psychosocial functioning in all its assessed aspects, i.e., lifestyle, employment of precautionary measures, depression, anxiety, and embarrassment. It was also noted that due to the specific character of the procedure (the necessity to operate an artificial implant), better mean results in assessment of the procedure functionality were achieved by patients presenting the goal-concentrated mode rather than emotions-concentrated mode of coping with the disease. Thus, it seems justified to state that assessment of biopsychological functioning may be a good criterion of the procedure effectiveness.
Highlights
Severe fecal incontinence describes a condition of complete loss of control over fundamental physiological functions and loss of abilities to fulfil psychosocial functions by the patients. e last-step procedure, that is, to restore hope for improvement of biopsychosocial functioning and quality of life determined by the patient’s health status is implantation of an artificial anal sphincter
Severe fecal incontinence describes a condition of a complete loss of control over bowel movements where the method of choice is the last-step procedure—an advanced reconstruction or abdominal stomy. ese procedures trigger a tremendous emotional strain and imply a conflict between the needs and expectations and the anticipated anxiety associated with the surgical procedure itself
In spite of the above, patients with severe fetal incontinence resulting from damage to the anal sphincter apparatus seek help in the field of reconstructive surgery in view of the devastating effect of loss of control over basic physiological functions upon their entire sphere of psychosocial functioning
Summary
Severe fecal incontinence describes a condition of a complete loss of control over bowel movements where the method of choice is the last-step procedure—an advanced reconstruction or abdominal stomy. ese procedures trigger a tremendous emotional strain and imply a conflict between the needs and expectations and the anticipated anxiety associated with the surgical procedure itself. In spite of the above, patients with severe fetal incontinence resulting from damage to the anal sphincter apparatus seek help in the field of reconstructive surgery in view of the devastating effect of loss of control over basic physiological functions upon their entire sphere of psychosocial functioning It results in a drastic decrease in quality and prosperity of life that are determined by the patient’s state of health. AAS is a soft silicone band that fulfils the role of a mechanical valve It is employed in patients with congenital (ankyloproctia) or acquired defects of the barrier mechanism (traumatic injuries of the pelvis or spinal cord and systemic diseases) in whom, due to lack of anal sphincter or its degradation, conservative treatment or other surgical procedures cannot be possibly performed. E authors took under consideration whether individual traits of the patient, such as coping with stress, affected the improvement of the aforementioned aspects of quality of life and whether assessment of psychosocial functioning of the patients might provide a good criterion of effectiveness of the procedure
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