Role of adynamic graciloplasty in intractable fecal incontinence: initial results from a tertiary centre in South India

Abstract

Background: Anal incontinence is a socially crippling disorder affecting up to 2% of general population. For patients with extensive sphincter damage who are not willing for permanent colostomy, either artificial bowel sphincter or muscle transposition like graciloplasty remains the last resort. This study was aimed at reporting the outcomes of adynamic graciloplasty in four of our patients with end stage fecal incontinence. Methods: This was a prospective observational study of all four patients with end stage fecal incontinence who underwent adynamic graciloplasty from January 2014 to January 2016. Results: Study group included four patients; etiology was perinatal injury in both female patients and penetrating trauma in both male patients. Surgery was uneventful in all cases. FISI scores improved in all cases. Conclusions: Adynamic graciloplasty is safe and feasible option in surgical management of select cases of intractable fecal incontinence with satisfactory results. It may be offered as a salvage surgery before condemning these patients to permanent colostomy.