Etiology and management of fecal incontinence.

摘要: Fecal incontinence is a challenging condition of diverse etiology and devastating psychosocial impact. Multiple mechanisms may be involved in its pathophysiology, such as altered stool consistency delivery contents to the rectum, abnormal rectal capacity or compliance, decreased anorectal sensation, pelvic floor anal sphincter dysfunction. A detailed clinical history physical examination are essential. Anorectal manometry, pudendal nerve latency studies, electromyography part standard primary evaluation. The evaluation idiopathic fecal require tests cinedefecography, spinal latencies, mucosal electrosensitivity. These permit both objective assessment focused therapy. Appropriate treatment options include biofeedback sphincteroplasty. Biofeedback has resulted 90 percent reduction episodes over 60 patients. Overlapping anterior sphincteroplasty been associated with good excellent results 70 common denominator between medical surgical groups necessity pretreatment physiologic assessment. It these that optimal therapeutic assignment. For example, terminal motor latencies (PNTML) most important predictor factor functional outcome. However, even experienced examiner's digit cannot assess PNTML. In absence neuropathy, an option. If neuropathy exists, however, then postanal total repair remain viable for incontinence. adequate muscle, encirclement procedures using synthetic materials muscle transfer techniques might considered. Implantation stimulating electrode into gracilis neosphincter artificial implantation other valid alternatives. final option diversion. This article reviews current status incidence well this disabling condition.