Incidence Of Fecal Incontinence Research Articles

To Investigate the Association between the Extent of Lateral Internal Anal Sphincterotomy and Postoperative Fecal Incontinence in Individuals with Chronic Anal Fissure

Background: The primary objective of this investigation was to evaluate the prevalence of fecal incontinence after surgery in individuals who underwent open lateral internal anal sphincterotomy up to the dentate line compared to those undergoing anal sphincterotomy (open internal) up to the height of the anal fissure. Methodology: This study was randomized and controlled and was carried out in Abbasi Shaheed Hospital, Karachi, at the department of surgery between February 2021 and July 2022. The study enrolled patients who were 15 years or older and presented to the outpatient department with chronic anal fissure, regardless of gender. Patients with concomitant anal disease, those with previous history of anorectal surgery & those with systemic neurological disease leading to fecal incontinence were excluded. Analysis of the collected data was performed using SPSS version 23. For quantitative variables, such as age, standard deviation and mean were calculated. Conversely, the qualitative variables, such as gender, location of anal fissure, Browning and Park's classification of incontinence, and final outcome(i.e. fecal incontinence at 5th postoperative day), were assessed using percentages and frequency. Results: In this study, 198 individuals who are chorincally suffering from anal fissure were identified and divided into two groups, Group A and B, each consisting of 99 patients. Group A underwent an open lateral internal anal sphincterotomy up to the level of the dentate line (referred to as the "dentate line group"), while Group B received an open lateral internal anal sphincterotomy up to the height of the fissure (known as the "height of fissure group").Fecal incontinence was assessed and compared between both groups on 5th postoperative day by using Browning and Park’s classification. The findings of this investigation indicated that open lateral anal sphincterotomy up to the level of the dentate line was associated with an 11.1% incidence of fecal incontinence, while a 3% incidence of fecal incontinence was observed in individuals who underwent anal sphincterotomy (lateral internal) up to the height of the anal fissure. Practical Implication: present study suggests that lateral internal anal sphincterotomy up to the height of anal fissure may be associated with a lower risk of fecal incontinence compared to the dentate line group. Conclusion: The data obtained from this study suggested that open anal sphincterotomy (lateral internal) up to the height of the anal fissure was linked to reduced incidence rates of postoperative fecal incontinence on the fifth day after surgery, as compared to open anal sphincterotomy (lateral internal) up to the level of the dentate line. Therefore, this modification should be used in future regularly in order to reduce this morbidity. Keywords: Fecal incontinence, Chronic Anal Fissure, Sphincterotomy.

The effect of nursing interventions on urinary, bowel and sexual dysfunction among post‐radical prostatectomy patients

AbstractProstate cancer is one of the commonest types of cancer in men worldwide. The primary treatment option for localized prostate cancer is radical prostatectomy. Unfortunately, a considerable proportion of men may experience long‐term post‐surgical sequelae is to determine the effect of nursing interventions on urinary, bowel, and sexual dysfunction among post‐radical prostatectomy patients. A quasi‐experimental (one group, pre‐test–post‐test) research design. We included 30 post‐radical prostatectomy patients in this study. Each patient was interviewed in five sessions. During these sessions, the information about the complications of RP, pelvic floor exercise training and sexual rehabilitation was given. International Consultation on Incontinence Questionnaire‐Urinary Incontinence‐Short Form (ICIQ‐UI‐SF), The Revised Faecal Incontinence Scale (RFIS) and Sexual Health Inventory for Men (SHIM) were used to evaluate the effect of nursing interventions. The study results demonstrate that the incidence of urinary and sexual dysfunction is high among patients post‐radical prostatectomy patients. Fortunately, urinary and sexual dysfunctions were improved post‐implementation of nursing intervention with statistically significant differences (p‐value <0.05). The incidence of faecal incontinence was 16.7% while it was 13.3% post‐nursing implementation with no statistically significant differences. Nursing intervention is effective in the management of urinary incontinence after radical prostatectomy within a short period time while the improvement in sexual dysfunction may need more time.

Universal Urogynecologic Consultation and Screening for Fecal Incontinence in Pregnant Women With a History of Obstetric Anal Sphincter Injury: A Cost-Effectiveness Analysis.

Obstetric anal sphincter injuries (OASIS) predispose for the development of fecal incontinence (FI), but management of subsequent pregnancy after OASIS is controversial. We aimed to determine if universal urogynecologic consultation (UUC) for pregnant women with prior OASIS is cost-effective. We performed a cost-effectiveness analysis of pregnant women with a history of OASIS modeling UUC compared with no referral (usual care). We modeled the route of delivery, peripartum complications, and subsequent treatment options for FI. Probabilities and utilities were obtained from published literature. Costs using a third-party payer perspective were gathered from the Medicare physician fee schedule reimbursement data or published literature converted to 2019 U.S. dollars. Cost-effectiveness was determined using incremental cost-effectiveness ratios). Our model demonstrated that UUC for pregnant patients with prior OASIS was cost-effective. Compared with usual care, the incremental cost-effectiveness ratio for this strategy was $19,858.32 per quality-adjusted life-year, below the willingness to pay a threshold of $50,000/quality-adjusted life-year. Universal urogynecologic consultation reduced the ultimate rate of FI from 25.33% to 22.67% and reduced patients living with untreated FI from 17.36% to 1.49%. Universal urogynecologic consultation increased the use of physical therapy by 14.14%, whereas rates of sacral neuromodulation and sphincteroplasty increased by only 2.48% and 0.58%, respectively. Universal urogynecologic consultation reduced the rate of vaginal delivery from 97.26% to 72.42%, which in turn led to a 1.15% increase in peripartum maternal complications. Universal urogynecologic consultation in women with a history of OASIS is a cost-effective strategy that decreases the overall incidence of FI, increases treatment utilization for FI, and only marginally increases the risk of maternal morbidity.

Usefulness of An Anal Sphincter Injury Mouse Model by Means of a Balloon Catheter and a New Method of Evaluating Anal Sphincter Function.

BackgroundThe incidence of fecal incontinence is ~2%, and the associated symptoms significantly impact daily life. New treatment methods including electrical stimulation and regenerative therapy using stem cells for fecal incontinence have been reported. We explored the usefulness of an anal sphincter injury mouse model by means of a balloon catheter and focused on the defecation status of mice as a novel method for evaluating anal function. We examined the utility of the mouse model of anal sphincter injury and the efficacy of electrical stimulation as a treatment modality using this model.MethodsA 10‐mm balloon catheter was used to create an anal sphincter injury model in mice. Sphincter function was evaluated in the noninjured (n = 4), injured (n = 4), noninjured electrical stimulation (n = 4), and injured electrical stimulation (n = 4) groups. Defecation status (defecation frequency in 24 h and fecal weight per stool) and pathological evaluation were used for comparison.ResultsThe defecation frequency increased and the fecal weight per stool decreased significantly in the anal sphincter injury model. Pathological evaluation revealed that anal sphincter tears occurred the day after the injury. Meanwhile, the defecation frequency improved on d 7, and the fecal weight per stool gradually normalized to that of the control group and exhibited significant sphincter muscle hypertrophy in the electrical stimulation group.ConclusionAnal sphincter injury using a balloon catheter in mice allowed us to create a uniform model. The evaluation of defecation status in mice is a useful method for comparatively evaluating anal function.

A Retrospective Investigation on Electric Bidet Use as a Possible Cause of Anal Incontinence.

Objectives: The present study aimed to explore whether symptoms of anal incontinence (AI) in patients who used electric bidet toilets to clean the anus may improve after discontinuing bidet use. Methods: Fifty-three patients with AI who habitually used the bidets before or after defecation and were examined between June 2019 and September 2020 were included in this retrospective study. Questionnaires on Likert-scaled items that assessed bidet use were administered at baseline. The sum of all points was regarded as the “bidet use score”. The patients were instructed to discontinue bidets until subsequent examination. Incontinence severity was documented using the fecal incontinence severity index (FISI) score. Results: Follow-up data were available for 49 patients (92%). Of those, 43 had fecal incontinence and 6 had only mucus discharge at baseline. The median duration between the baseline and follow-up was 4 weeks. The median FISI score was significantly reduced at the follow-up [baseline vs. follow-up: 15 (range: 3-43) vs. 10 (range: 0-43); P < 0.0001]. The incidence of fecal incontinence was significantly lower at the follow-up than at the baseline (59% vs. 88%, P = 0.003). A higher maximum squeeze pressure and the absence of associated factors that may cause AI (such as rectoanal intussusception and/or rectocele, mucosal prolapse, and previous anorectal surgery) were significantly associated with a reduction of at least 50% in the FISI scores at follow-up; however, this was not observed for the bidet use score. Conclusions: Our findings suggest that electric bidet use is a possible cause of AI.

Diagnosis and treatment of faecal incontinence – the current state of knowledge, literature review

Incontinence significantly affects the daily functioning of patients and can severely deteriorate their quality of life, leading to social disability. The most common causes of gas and faecal incontinence include obstetric injuries (mechanical trauma to the sphincter muscles or stretching of the pudendal nerve during vaginal delivery) and complications after anorectal procedures. The incidence of faecal incontinence is estimated by various authors between 2.2 and 25%. The problem affects all age groups, but mainly the elderly, with higher rates among women than men. The paper presents a review of diagnostic and therapeutic methods for incontinence based on the latest reports. Most researchers agree that, except for extensive sphincter injuries, conservative methods are the mainstay treatment for faecal incontinence, while instrumental or surgical procedures are used in the event of their failure. Despite the multitude of therapeutic methods for this difficult disease, there is no ideal procedure as the aetiology of incontinence is usually multifactorial, hence the therapeutic management should be incorporated on several levels. Treatment should be performed in a centre dedicated to proctological patients, equipped with appropriate diagnostic tools and specialist personnel.

47 Universal screening for fecal incontinence in pregnant women with a history of obstetric anal sphincter injury: A cost-effectiveness analysis

Fecal incontinence (FI), the involuntary passage of solid or liquid stool or mucus from the rectum, can have devastating effects on quality of life and presents a significant healthcare cost burden. Obstetric anal sphincter injuries (OASIS) are a known risk factor for the development of FI, but management of subsequent pregnancy after OASIS is controversial. The objective of this study is to determine if universal urogynecologic screening for FI for pregnant women with prior OASIS is cost-effective. We performed a cost-effectiveness analysis using a decision tree model. For pregnant women with history of OASIS in a previous delivery, we modeled the option of referral to urogynecology (FI screening) compared to no referral (usual care). From there, we modeled the option of proceeding with an elective cesarean delivery or trial of labor as well as the actual delivery method (vaginal, planned cesarean, or unplanned cesarean). A second sub-tree was constructed with branch points modeling the probabilities of various maternal peripartum complications. A third sub-tree modeled the treatment options for patients who developed FI. Probabilities used in the model were obtained from the published literature using PubMed to find relevant primary sources. Utilities used in the model were obtained from the Tufts Medical Center Cost-Effectiveness Analysis Registry if available. Otherwise, they were obtained from the published literature. We used the cost perspective of a third-party payer. Costs were gathered from the Medicare physician fee schedule reimbursement data or published literature and were converted to 2019 US dollars via consumer price index tables and year-specific currency conversion rates to account for inflation. Our primary outcome of cost-effectiveness was determined by using the incremental cost-effectiveness ratio (ICER). Model robustness was assessed using multiple 1-way sensitivity analyses. Our model demonstrated that universal FI screening and referral to urogynecology for pregnant patients with prior OASIS was cost-effective. Compared to the usual care strategy of no screening, the ICER for this strategy was $19,858.32/QALY, well below the WTP threshold of $50,000/QALY. Screening for FI reduced the ultimate rate of FI by 2.65% and reduced the ultimate rate of patients living with untreated FI by 15.87%. Screening increased the use of pelvic floor PT by 14.14% while rates of second and third-line surgical FI treatments (sacral neuromodulation or sphincteroplasty) increased by only 2.48% and 0.58%, respectively. The screening strategy reduced the rate of vaginal delivery by 24.84%, which in turn led to a 1.15% increase in the rate of peripartum maternal complications. Universal screening for fecal incontinence in women with a prior history of OASIS is a cost-effective strategy that decreases the overall incidence of FI, increases the utilization of treatment for FI, and only marginally increases the risk of maternal morbidity.

Patient's characteristics and incidence of fecal incontinence after primary repair of Obstetric Anal Sphincter Injuries (OASIS) at three Indonesian tertiary hospitals in 2014-2016.

IntroductionObstetric Anal Sphincter Injuries (OASIS) is a common complication of vaginal delivery. The incidence was 4.53 % of total vaginal deliveries. OASIS is associated with an increased risk of fecal incontinence (FI), which affects one’s quality of life. The incidence of OASIS and FI varied from study to study. In this study, we described the characteristics of patients with OASIS at three Indonesian tertiary hospitals in 2014−2016 and FI outcome among those patients.MethodologyThis is a descriptive study on the characteristics of OASIS patients after primary repair in three tertiary hospitals: dr. Cipto Mangunkusumo National General Hospital, Persahabatan General Hospital and Fatmawati General Hospital from 2014 to 2016. From a total of 234 patients, only 58 patients could be contacted and interviewed using Revised Fecal Incontinence Score (RFIS) questionnaires. Out of the 58 patients, only 16 patients came for transperineal ultrasound. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.ResultsFrom a total of 234 patients, the mean age was 26.6 years old with a mean Body Mass Index (BMI) of 24.8 kg/m2. Most of the patients were nulliparous (67.5 %) and the median duration of second stage of labor was 45 min. Episiotomy was not performed on most patients (59.4 %) and most of them underwent spontaneous vaginal delivery (65.4 %) with mean baby’s birthweight of 3217 g. From 58 interviewed patients, three patients complained of FI (5.2 %). Sixteen patients came for transperineal ultrasound examination, and only one of them had FI. Anal sphincter defects were identified in five patients, comprising three external anal sphincter (EAS) and two internal anal sphincter (IAS) defects. All five patients did not experience FI. One patient who had FI had no anal sphincter defect.DiscussionThis is a pilot study for the incidence of FI among the OASIS population in Jakarta, Indonesia. The incidence of FI observed in this study was relatively low (3 out of 58 patients) compared to other studies. This could be due to differences in study population. The fact that the patient with FI had intact anal sphincter suggests that other factors may contribute to the development of FI in addition to the integrity of the anal sphincter. These factors may include pelvic floor muscle and innervation of the surrounding tissues.ConclusionThe outcomes of primary repair of OASIS varied between studies. Patients’ characteristics might play an important role in the development of OASIS as well as the outcome after repair. Further studies with larger sample size are needed.

Research progress of sacral neuromodulation procedure in the treatment of chronic constipation and fecal incontinence

Sacral neuromodulation(SNM) procedure has become a new therapy to treat chronic constipation and fecal incontinence. The surgical procedure is easy and safe. It has a small incision compared with traditional surgery and is mainly used in patients whose traditional treatment was unsuccessful. Chronic constipation is one of the most common digestive symptoms. The quality of life in patients with severe constipation has decreased greatly. Although the incidence of fecal incontinence in China is not as high as that of constipation, it also seriously affects the life of the patients, resulting in a decline in the quality of life. Although the mechanism of SNM is uncertain, with more studies conducted, understanding has become more profound, and the curative effect has been recognized. SNM can improve the symptoms and the quality of life. Many studies have reported SNM treatment. Furthermore, some trials on SNM have been conducted. It is used after colorectal resections to promote symptoms of bowel dysfunction. However, few studies reported regarding SNM for constipation and fecal incontinence in China, and knowledge regarding SNM is limited. In this article, we will mainly discuss SNM in the treatment of chronic constipation and fecal incontinence, and its research progress on the mechanism and method, surgical procedure, effectiveness, complications, postoperative contraindications, and the population who need to pay attention, in order to provide reference for the treatment of SNM in China.

Effects of Kegel on fecal incontinence in patients with anal endoscopic microsurgery after surgery

Objective To study the clinical efficacy of Kegel on fecal incontinence in patients with anal endoscopic microsurgery. Methods Totally 60 patients with anal endoscopic microsurgery were randomly selected by purpose sampling method from October 2013 to June 2016, and they were divided into the control group and the observation group according to the random number table method, with 30 cases in each group. Patients in the control group received routine care, while patients in the observation group was trained by Kegel exercises before and after surgery. Incidence of fecal incontinence, anal function excellent rate and duration of fecal incontinence were observed and compared between two groups. Results The incidence rate of fecal incontinence in the observation group was 3.3% (1/30) , while that of the control group was 23.3% (7/30) (P=0.052) . The postoperative duration of fecal incontinence in the observation group was (3.3±0.5) d, while that of the control group was (5.3±2.4) d (t=4.468, P<0.05) . Four days after surgery, the number of patients with good anal function in evaluation in the observation was 28, while that of the control group was 22 (Z=-2.020, P<0.05) . Conclusions Kegel exercises before and after anal endoscopic microsurgery can effectively improve patients' anal function and shorten the duration of fecal incontinence. This method is simple, practical and can be widely used. Key words: Fecal incontinence; Kegel excercises; Anal endoscopic microsurgery

Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors

ObjectiveTo investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors. Study designWe performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation. ResultsOf the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01). ConclusionLocal or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors.

Correlation of Histopathology With Anorectal Manometry Following Stapled Hemorrhoidopexy

PurposeThe removal of smooth muscle during stapled hemorrhoidopexy raises concerns regarding its effects on postoperative anorectal function. The purpose of this study was to evaluate the correlation between the amount of muscle removed and changes in anorectal manometry following stapled hemorrhoidopexy.MethodsPatients with symptomatic II, III, or IV degree hemorrhoids that underwent stapled hemorrhoidopexy between January 2008 and May 2011 were included in this study. Anorectal manometry was performed preoperatively and at three months postoperatively. The resected doughnuts were examined histologically, and the thicknesses of muscle fibers were evaluated.ResultsEighty-five patients (34 males) with a median age of 47 years were included. Muscularis propria fibers were identified in 63 of 85 pathologic specimens (74.1%). The median thickness of the muscle fibers was 1.58 ± 1.21 mm (0 to 4.5 mm). The mean resting pressure decreased by approximately 7 mmHg after operation in the 85 patients (P = 0.019). In patients with muscle incorporation, there was a significant difference in mean resting pressure (P = 0.041). In the analysis of the correlation of the difference in anorectal manometry results ([the result of postsurgical anorectal manometry] - [the result of presurgical anorectal manometry]) to the thickness of muscle fibers, no significant differences were seen. No patients presented with fecal incontinence.ConclusionAlthough the incidence of fecal incontinence is very low, muscle incorporation in the resected doughnuts following stapled hemorrhoidopexy may affect anorectal pressure. Therefore, surgeons should endeavor to minimize internal sphincter injury during stapled hemorrhoidopexy.

Incidence of Obesity in Female Patients with Fecal Incontinence

Background: The aim of this study was to evaluate the correlation between body mass index (BMI) and the incidence of fecal incontinence in female patients. Patients and Method: In this study, data of 98 female patients presenting with fecal incontinence and of 98 healthy control subjects were retrospectively analyzed. Results: In 34% of the study patients and 50% of the controls, body mass indices were within the normal range (BMI 18.5–24.9 kg/m²) (Mann-Whitney U test: p > 0.05). 29% of the study patients and 32% of the control group were overweight (BMI 25.0–29.9 kg/m²) (U test: p > 0.05). 26% of the study group and 9% of the control collective were identified as obese according to the WHO classification I (U test: p = 0.033). 5% of the patients and 6% of the controls were diagnosed as obese according to the WHO classification II (U test: p > 0.05), and 2% of the patients and 1% of the controls fulfilled the definition for obesity based on the WHO classification III (U test: p > 0.05). Conclusion: Since the percentage of females suffering from obesity is significantly higher in patients presenting with fecal incontinence when compared to healthy controls, weight loss should be pointed out strongly in a conservative treatment of fecal incontinence.

Medium-term results of anal advancement flap compared with lateral sphincterotomy for the treatment of anal fissure

Anal fissure is associated with anal pain and bleeding. Lateral internal sphincterotomy (LIS) has been a common form of surgical management. This can however cause incontinence and hence an equally effective alternative without this risk would be ideal. Anal fissurectomy and an anal advancement flap (AAF) have been used as an alternative to LIS. We carried out a retrospective analysis of the results of AAF and LIS for the treatment of anal fissure. Fifty patients underwent AAF and a further 50 cases were chosen who had undergone LIS over the same time period. Patient and procedural data were collected including post-operative course. Presenting symptoms included anal pain (94%), rectal bleeding (77%) and constipation (15%). Mean (±SD) follow-up was 20 ± 12 months in the AAF group vs 22 ± 12.5 months in the LIS group. Healing of fissure was achieved in 96% of patients after AAF and 88% after LIS (p = 0.27). Resolution of symptoms was achieved in 90% after AAF and 72% of patients after LIS (p = 0.04). LIS was associated with an increased incidence of readmission with infection and pain (8% vs 4%, p = 0.35). Seven patients whom had undergone successful AAF with complete resolution of symptoms had previously had LIS with failure of symptom relief. There was no incidence of faecal incontinence in either group. AAF is associated with a higher incidence of symptomatic relief and fissure healing and lower incidence of complications when compared with LIS. AAF is effective at healing fissures which are refractory to LIS.

Faecal incontinence.

There is an increased incidence of faecal incontinence in people who have chronic diseases such as diabetes or who are taking broad spectrum antibiotics or beta blockers.

Complications and results of lateral internal sphincterotomy for chronic anal fissure

Background Treatment of chronic anal fissure has been directed at relaxing increased sphincter tone. Lateral internal sphincterotomy (LIS), since its introduction in 1951 by Eisenhammer, has been considered the gold standard approach with healing rate of approaching 95%. However, concerns have been raised about postoperative impairment of faecal incontinence after LIS. Actually, the incidence of faecal incontinence reported in literature varies widely from 1.3% to 30% or more. Several factors have been associated to affect LIS outcomes and morbidities, first of all accurate surgical technique, length of sphincterotomy, previous anorectal surgery, additional procedures and obstetric history.

Incidence of Fecal Incontinence After Childbirth

Incidence of Fecal Incontinence After Childbirth

Crohnʼs perianal fistulas and the incidence of fecal incontinence

Crohnʼs perianal fistulas and the incidence of fecal incontinence

Crohnʼs perianal fistulas and the incidence of fecal incontinence

Fistulizing perianal Crohn's disease (CD) can cause significant morbidity including fecal incontinence. The rate of fecal incontinence in these patients (pts) varies in the literature. The purpose of this study was to assess the rate of fecal incontinence in pts with Crohn's perianal fistulas and to determine if there is a difference in outcomes between those pts who have undergone primarily medical or surgical treatment for their perianal disease. The medical records of pts who presented to the GI Clinic at a single academic medical center between 1/01 and 6/05 with perianal CD were reviewed. Demographic data and information regarding treatment was recorded. Mailed questionnaires and telephone interviews were conducted to determine the Fecal Incontinence Severity Index (FISI) score and patient satisfaction with medical and surgical outcomes. Of 118 pts identified with Crohn's perianal fistulas, a total of 65 (55%) completed the questionnaire. 43 (66%) pts had surgical treatment while 22 (34%) had medical treatment only. The overall rate of fecal incontinence was high with 48% of all pts having ≥ 1 episode a week of solid stool incontinence. There was no difference between the medical and surgical cohorts (55% vs. 44%; p=.45) The median FISI for the medical group was 34, (range 0 - 59) while the median FISI for the surgical cohort was 29 (range 0-56; p=.37). The type of surgical treatment did not affect outcome. Surgical pts who had less invasive operations (incision and drainage or seton placement) had a median FISI of 29, and pts who underwent more aggressive surgical treatment (fistulotomy, fistulectomy, or advancement flap) had a median FISI of 43 (range 5-54; p=.11). All pts were asked to rate their degree of satisfaction (1 = poor and 5 = excellent). Pearson's product moment analysis revealed that there did not appear to be a strong relationship between level of satisfaction and FISI score (correlation = -0.18, p=.17). The rate of fecal incontinence in pts with perianal CD is high. There is not a significant difference in the degree of fecal incontinence between pts treated medically or surgically for perianal CD, nor is there a significant difference in fecal incontinence with the different surgical procedures. Patients with higher FISI scores are not necessarily less satisfied with their results.

Fecal Incontinence Common After Childbirth

Obstetric delivery is thought to be a primary cause of fecal incontinence. Investigators surveyed all women who delivered in Oregon during a 6-month period in 2002 to estimate the incidence of fecal incontinence at 3 to 6 months postpartum. …