Abstract
Background Post-obstetric neuropathic faecal incontinence is a complex disorder of impaired motor function involving the sphincters and pelvic floor, often associated with impaired rectal evacuation and anorectal anaesthesia [1]. Direct trauma to the anal sphincter complex can give immediate problems or problems later in life. The initial therapy should be conservative. Patients with anatomic sphincter defect or with extensive sphincter damage, muscle loss or pudendal neuropathy are very likely to need surgery. Several surgical approaches have been proposed, but results still remain disappointing, although quality of life seems to be improved [2]; after the initial enthusiasm, the role of artificial bowel sphincter (ABS) has been scaled-down. These problems are even harder to face in elderly patients previously operated on with poor outcome for faecal incontinence.
Highlights
Post-obstetric neuropathic faecal incontinence is a complex disorder of impaired motor function involving the sphincters and pelvic floor, often associated with impaired rectal evacuation and anorectal anaesthesia [1]
Surgical treatment of post-obstetric faecal incontinence usually consists of sphincter repair if there is clinical or ultrasonography evidence of sphincter disruption or failed SNS, reserving post-anal repair for the treatment of incontinence in patients with history of traumatic or prolonged labor associated with physiologic evidence of pudendal nerve injury, low anal canal pressures, anal anesthesia, and prolonged pudendal nerve conduction time
gluteus maximus transposition (GMT) is not widely used for treatment of post-obstetric faecal incontinence, but physiologic studies suggest that the procedure may improve resting and squeeze anal canal pressures and elongate the high pressure zone [4,5]
Summary
From 26th National Congress of the Italian Society of Geriatric Surgery Naples, Italy. From 26th National Congress of the Italian Society of Geriatric Surgery Naples, Italy. 19-22 June 2013
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
