Skip to main content

Future Perspectives in Management and Research of Fecal Incontinence

  • Chapter
Fecal Incontinence

Abstract

As a common denominator of all the clinical aspects treated in this book, there is the awareness of potential benefits derived from rational management of fecal incontinence (FI) and the need for further efforts to improve the effectiveness of traditional and new treatments. Indeed, although progress made in this field during the last few decades has been significant, the lack of detailed knowledge in the physiology of fecal continence far too frequently makes the application of therapeutic procedures empiric and pragmatic. Moreover, there are discrepancies between countries and regions in referring patients to centers dedicated to FI management. This causes different attitudes in performing a homogeneous diagnostic workup, in application of similar strict selection criteria to the variety of available treatments, and in reporting results of the applied therapies. Worldwide, national institutes for health inadequately support medical research on FI treatment, even though the social, economic, and clinical importance of FI to society has been very well recognized. On the other hand, research into FI is all too frequently sponsored only by companies with a commercial interest in the subject.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Whitehead WE, Wald A, Norton NJ (2004) Priorities for treatment research from different professional perspectives. Gastroenterol 126:S180–S185

    Article  Google Scholar 

  2. Deutekom M, Dobben AC, Terra MP et al (2007) Clinical presentation of fecal incontinence and anorectal function: what is the relationship? Am J Gastroenterol 102:351–361

    Article  PubMed  Google Scholar 

  3. Nelson RL (2004) Epidemiology of fecal incontinence. Gastroenterology 126(1 Suppl l):S3–7

    Article  PubMed  Google Scholar 

  4. Fitzgerald MP, Weber AM, Howden N et al (2007) Risk factors for anal sphincter tear during vaginal delivery. Obstet Gynecol 109:29–34

    PubMed  Google Scholar 

  5. Richter HE, Fielding JR, Bradley CS et al (2006) Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears. Obstet Gynecol 108:1394–1401

    PubMed  Google Scholar 

  6. Thornton MJ, Lubowski DZ (2006) Obstetric-induced incontinence: a black hole of preventable morbidity. Aust NZ J Obstet Gynaecol 46:468–473

    Article  Google Scholar 

  7. Gourcerol G, Gallas S, Michot F et al (2006) Sacral nerve stimulation in fecal incontinence: are there factors associated with success? Dis Colon Rectum 49:1–10

    Article  Google Scholar 

  8. Trowbridge ER, Morgan D, Trowbridge MJ et al (2006) Sexual function, quality of life, and severity of anal incontinence after anal sphincteroplasty. Am J Obstet Gynecol 195:1753–1757

    Article  PubMed  Google Scholar 

  9. Pla-Marti V, Moro-Valdezate D, Alos-Company R et al (2007) The effect of surgery on quality of life in patients with faecal incontinence of obstetric origin. Colorectal Dis 9:90–95

    Article  PubMed  CAS  Google Scholar 

  10. Hetzer FH, Hahnloser D, clavien PA et al (2007) Quality of life and morbidity after permanent sacral nerve stimulation for fecal incontinence. Arch Surg 142:8–13

    Article  PubMed  Google Scholar 

  11. Rockwood TH (2004) Incontinence severity and QOL scales for fecal incontinence. Gastroenterology 126(1 Suppl l):S106–113

    Article  PubMed  Google Scholar 

  12. Rockwood TH, Church JM, Fleshman JW et al (2000) Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 43:9–16

    Article  PubMed  CAS  Google Scholar 

  13. Rothbarth J, Bemelman WA, Meijerink WJ et al (2001) What is the impact of fecal incontinence on quality of life? Dis Colon Rectum 44:67–71

    Article  PubMed  CAS  Google Scholar 

  14. Eypasch E, Williams JI, Wood-Dauphinee S et al (1995) Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg 82:216–222

    Article  PubMed  CAS  Google Scholar 

  15. Sakakibara R, Shinotoh H, Uchiyama T et al (2001) Questionnaire-based assessment of pelvic organ dysfunction in Parkinson’s disease. Auton Neurosi 92:76–85

    Article  CAS  Google Scholar 

  16. Wiesel PH, Norton C, Roy AJ et al (2000) Gut focused behavioural treatment (biofeedback) for constipation and faecal incontinence in multiple sclerosis. J Neurol Neurosurg Psychiatry 69:240–243

    Article  PubMed  CAS  Google Scholar 

  17. Bai Y, Yuan Z, Wang W et al (2000) Quality of life for children with fecal incontinence after surgically corrected anorectal malformation. J Pediatr Surg 35:462–464

    Article  PubMed  CAS  Google Scholar 

  18. Bug GJ, Kiff ES, Hosker G (2001) A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG 108:1057–1067

    Article  PubMed  CAS  Google Scholar 

  19. Sperber AD (2004) Translation and validation of study instruments for cross-cultural research. Gastroenterology 126(1 Suppl 1):S124–128

    Article  PubMed  Google Scholar 

  20. Gearhart S, Hull T, Floruta C (2005) Anal manometric parameters: predictors of outcome following anal sphincter repair? J Gastrointest Surg 9:115–120

    Article  PubMed  Google Scholar 

  21. Prott G, Hansen R, Badcock C et al (2005) What is the optimum methodology for the clinical measurement of resting anal sphincter pressure? Neurogastroenterol Motil 17:595–599

    Article  PubMed  CAS  Google Scholar 

  22. Siprouidhis L, Al Abkari M, El Alaoui M et al (2005) Low rectal volumes in patients suffering from fecal incontinence: what does it mean? Aliment Pharmacol Ther 22:989–996

    Article  Google Scholar 

  23. Deutekom M, Terra MP, Dijkgraaf MGW et al (2006) Patients’ perception of tests in the assessment of faecal incontinence. Br J Radiol 79:94–100

    Article  PubMed  CAS  Google Scholar 

  24. Rattan S (2005) The internal anal sphincter: regulation of smooth muscle tone and relaxation. Neurogastroenterol Motil 17(Suppl l):50–59

    Article  PubMed  Google Scholar 

  25. Enck P, Hinninghofen H, Merlett R et al (2005) The external anal sphincter and the role of surface electromyography. Neurogastroenterol Motil 17(Suppl 1): 60–67

    Article  PubMed  Google Scholar 

  26. Azpiroz F, Fernandez-Fraga X, Merlett R et al (2005) The puborectalis muscle. Neurogastroenterol Motil 17(Suppl l):68–72

    Article  PubMed  Google Scholar 

  27. Saranovic D, Barisic G, Krivokapic Z et al (2007) Endoanal ultrasound of anorectal diseases and disorders: technique, indications, results and limitations. Eur J Radiol 61:480–489

    Article  PubMed  Google Scholar 

  28. Mortele KJ, Fairhurst J (2007) Dynamic MR defecography of the posterior compartment: indications, techniques and MRI features. Eur J Radiol 61:462–472

    Article  PubMed  Google Scholar 

  29. Maglinte DDT, Bartram C (2007) Dynamic imaging of posterior compartment pelvic floor dysfunction by evacuation proctography: techniques, indications, results and limitations. Eur J Radiol 61:454–461

    Article  PubMed  Google Scholar 

  30. Dobben AC, Terra MP, Berghmans B et al (2006) Functional changes after physiotherapy in fecal incontinence. Int J Colorectal Dis 21:515

    Article  PubMed  Google Scholar 

  31. Maeda Y, Vaizey CJ, Kamm MA (2007) Long-term results of perianal silicone injection for faecal incontinence. Colorectal Dis 9:357–361

    Article  PubMed  CAS  Google Scholar 

  32. Ratto C, Parello A, Donisi L et al (2007) Anal Gatekeeper: a new bulking agent for patients with fecal incontinence. Abstract PI8. In: Proceedings ASCRS 2007 Annual Meeting, June 2–6, Cervantes Convention Center at America’s Center, St. Louis, MO, USA

    Google Scholar 

  33. Schrag HJ, Ruthmann O, Doll A et al (2006) Development of a novel, remote-controlled artificial bowel sphincter through microsystems technology. Artif Organs 30:855–862

    Article  PubMed  Google Scholar 

  34. Tillin T, Gannon K, Feldman RA et al (2006) Third-party prospective evaluation of patient outcomes after dynamic graciloplasty. Br J Surg 93:1402–1410

    Article  PubMed  CAS  Google Scholar 

  35. Ruthmann O, Fisher A, Hopt UT et al (2006) Dynamic graciloplasty vs artificial bowel sphincter in the management of severe fecal incontinence. Chirurg 77:926–938

    Article  PubMed  CAS  Google Scholar 

  36. Maslekar S, Gardiner AB, Duthie GS (2007) Anterior anal sphincter repair for fecal incontinence: good long-term results are possible. J Am Coll Surg. 204:40–46

    Article  PubMed  Google Scholar 

  37. Barisic GI, Krivokapic ZV, Markovic VA et al (2006) Outcome of overlapping anal sphincter repair after 3 months and after a mean of 80 months. Int J Colorectal Dis 21:52–56

    Article  PubMed  Google Scholar 

  38. Oberwalder M, Dinnewitzer A, Baig MK et al (2006) Do internal anal sphincter defects decrease the success rate of anal sphincter repair? Tech Coloproctol 10:94–97

    Article  PubMed  CAS  Google Scholar 

  39. Hayes J, Shatari T, Toozs-Hobson P et al (2006) Early results of immediate repair of obstetric third-degree tears: 65% are completely asymptomatic despite persistent sphincter defects in 61%. Colorectal Dis 9:332–336

    Article  Google Scholar 

  40. Kairaluoma MV, Raivio P, Aarnio MT et al (2004) Immediate repair of obstetric anal sphincter rupture: medium-term outcome of the overlap technique. Dis Colon Rectum 47:1358–1363

    Article  PubMed  Google Scholar 

  41. Steele SR, Lee P, Mullenix PS et al (2006) Is there a role for concomitant pelvic floor repair in patients with sphincter defects in the treatment of fecal incontinence? Int J Colorectal Dis 21: 508–514

    Article  PubMed  Google Scholar 

  42. Kapoor DS, Thakar R, Sultan AH (2005) Combined urinary and faecal incontinence. Int Urogynecol J 16:321–328

    Article  Google Scholar 

  43. Soligo M, Salvatore S, Milani R et al (2003) Double incontinence in urogynecologic practice: a new insight. Am J Obstet Gynecol 189:438–443

    Article  PubMed  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag Italia

About this chapter

Cite this chapter

Ratto, C., Parello, A., Donisi, L., Litta, F., Doglietto, G.B. (2007). Future Perspectives in Management and Research of Fecal Incontinence. In: Ratto, C., Doglietto, G.B., Lowry, A.C., PÃ¥hlman, L., Romano, G. (eds) Fecal Incontinence. Springer, Milano. https://doi.org/10.1007/978-88-470-0638-6_37

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-0638-6_37

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0637-9

  • Online ISBN: 978-88-470-0638-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics