Piborectoplasty: New Technique for the Repair of Fecal Incontinence

Abstract

A new technique for the treatment of fecal incontinence is presented. It was practiced in 31 patients with incontinence of formed stools. Incontinence was idiopathic in 21 patients and traumatic with excessive loss of sphincteric muscle in 10. Manometric and electromyographic studies were performed before and after the operation. The procedure comprises the fashioning of a curvilinear incision between rectal neck orifice and coccyx. The supralevator region is entered. A Teflon sling 20 × 2 cm is sutured at its middle to upper part of the rectal neck (anal canal). The 2 limbs of the sling are then withdrawn forward through 2 incisions on both pubic rami and are sutured to the pubic bone. Good results have been achieved in 83.8%. The continent effect of the operation is related to increase of rectal neck pressure and possible rectal neck elongation. The operation is indicated in fecal incontinence, particularly of the idiopathic type and traumatic injuries with excessive sphincteric loss. It is simple, easy and was done under no cover of colostomy.