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fecal incontinence in men:Causes and clinical and manometric features

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World Journal of Gastroenterology 2014年第24期20卷 7933-7940页

作者： Teresa Munoz-Yagüe Pablo Solis-Munoz Constanza Ciriza de los Rios Francisco Muoz-Garrido Jesus Vara Jose Antonio Solis-Herruzo Department of Gastroenterology the University Hospital "12 de Octubre"28041-MadridSpain Institute of Liver Studies King’s College HospitalLondon SE5 9RSUnited Kingdom Pelvic Floor Unit the University Hospital "12 de Octubre"28041-MadridSpain Research Center University Hospital "12 de Octubre"Complutense University28041-MadridSpain

AIM:To determine the causes and characteristics of fecal incontinence in men and to compare these features with those presented by a group of women with the same ***:We analyzed the medical history,clinical and manometric data from 119 men with fecal incontinence studied in our unit and compared these data with those obtained from 645 women studied for the same *** to treatment was evaluated after 6 mo of ***:Fifteen percent of patients studied in our unit for fecal incontinence were *** took longer than women before asking for medical *** surgery was the most common risk factor for men related to fecal *** diarrhea was present in more than 40%of patients in both *** resting and external anal sphincter pressures were more frequent in *** significant differences existed between the sexes regarding rectal sensitivity and recto-anal inhibitory *** 17.8%of men,all presenting soiling,manometric findings did not justify fecal *** to treatment was good in both groups,as 80.4%of patients improved and fecal incontinence disappeared in 13.2%of ***:In our series,it was common that men waited longer in seeking medical help for fecal ***-rectal surgery was the major cause of this *** diarrhea was a predisposing factor in both *** differences between groups were limited to an increased frequency of hypotony of the external anal sphincter in *** incontinence was controllable in most patients.

关键词： fecal incontinence Gender Ano-rectal surgery Ano-rectal manometry Treatment Biofeedback

fecal incontinence - Challenges and solutions

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World Journal of Gastroenterology 2017年第1期23卷 11-24页

作者： Nallely Saldana Ruiz Andreas M Kaiser Department of Surgery Division of Colorectal SurgeryKeck School of MedicineUniversity of Southern California Department of Surgery Division of Colorectal SurgeryKeck School of MedicineUniversity of Southern California

fecal incontinence is not a diagnosis but a frequent and debilitating common final pathway symptom resulting from numerous different causes. incontinence not only impacts the patient’s self-esteem and quality of life but may result in significant secondary morbidity, disability, and cost. Treatment is difficult without any panacea and an individualized approach should be chosen that frequently combines different modalities. Several new technologies have been developed and their specific roles will have to be defined. The scope of this review is outline the evaluation and treatment of patients with fecal incontinence.

关键词： fecal incontinence Sphincteroplasty Sacral nerve stimulation Endorectal ultrasound New technologies Quality of life

Garg incontinence scores: New scoring system on the horizon to evaluate fecal incontinence. Will it make a difference?

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World Journal of Gastroenterology 2024年第3期30卷 204-210页

作者： Petr Tsarkov Inna Tulina Parvez Sheikh Darya D Shlyk Pankaj Garg Department of Colorectal Surgery Sechenov First Moscow State Medical UniversityMoscow 119991Russia Department of Oncologic Colorectal Surgery Sechenov First Moscow State Medical UniversityMoscow 119991Russia Department of Colorectal Surgery Saifee HospitalMumbai 400004MaharashtraIndia Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia

The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–*** authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the *** IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a *** associated social stigmatization often leads to significant under-reporting of the condition,which further impairs *** important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their *** to this,the management becomes even more *** issue is resolved up to a considerable extent by a scoring *** were several scoring systems in use for the last three *** prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,*** Hospital or Vaizey’s scores,and the FI severity ***,there were several shortcomings in these scoring *** the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring *** main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into *** GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring *** to this,GIS in

关键词： fecal incontinence Scoring system Urge Stress Flatus

Treatment strategies in obstructed defecation and fecal incontinence

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World Journal of Gastroenterology 2006年第20期12卷 3168-3173页

作者： Marat Khaikin Steven D Wexner Department of Colorectal Surgery Cleveland Clinic Florida WestonFL 33331United States

Obstructed defecation （OD） and fecal incontinence （FI） are challenging clinical problems, which are commonly encountered in the practice of colorectal surgeons and gastroenterologists. These disorders sodally and psychologically distress patients and greatly impair their quality of life. The underlying anatomical and pathophysiological changes are complex, often incompletely understood and cannot always be determined. As a consequence, many medical, surgical, and behavioral approaches have been described, with no panacea. Over the past decade, advances in an understanding of these disorders together with rational and similar methods of evaluation in anorectal physiology laboratories （ARP）, radiology studies, and new surgical techniques have led to promising results. In this brief review, we discuss treatment strategies and recent updates on clinical and therapeutic aspects of obstructed defecation and fecal incontinence.

关键词： Obstructed defecation fecal incontinence Treatment

Bio-feedback treatment of fecal incontinence: Where are we, and where are we going?

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World Journal of Gastroenterology 2005年第31期11卷 4771-4775页

作者： Giuseppe Chiarioni Barbara Ferri Antonio Morelli Guido Iantorno Gabrio Bassotti Gastroenterological Rehabilitation Division of the University of Verona Gastroenterology and Digestive Endoscopy Institute Gastroenterology and Hepatology Section Digestive Motility Unit

fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma.

关键词： Biofeedback fecal incontinence

Impact of fecal incontinence on quality of life

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World Journal of Gastroenterology 2009年第26期15卷 3276-3282页

作者： Lynne Bartlett Madeleine Nowak Yik-Hong Ho School of Public Health Tropical Medicine and Rehabilitation Scienceswithin North Queensland Centre for Cancer ResearchJames Cook University School of Medicine and Dentistry within the North Queensland Centre for Cancer ResearchJames Cook University

AIM:To explore the impact of fecal incontinence (FI) on quality of life (QOL) of patients attending urogynecology and colorectal clinics (CCs).METHODS:Cross-sectional study of 154 patients (27 male) with FI,who attended the clinics at a regional hospital in North Queensland,Australia in 2003 and 2004,and completed the fecal incontinence Quality of Life Scale (FIQL:1=very affected;4=not affected).RESULTS:More than 22% of patients had their QOL affected severely by *** reported that they had not previously been asked about FI by a medical practitioner nor did they voluntarily disclose its *** median FIQL scores for all participants were:lifestyle=3.24;coping=2.23;depression=2.42;and embarrassment=*** frequency of soiling had a negative effect on all four FIQL scales (P fecal loss.

关键词： Quality of life fecal incontinence Rural health Colorectal cancer Urogynecology

Sphincteroplasty for fecal incontinence in the era of sacral nerve modulation

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World Journal of Gastroenterology 2010年第42期16卷 5267-5271页

作者： Donato F Altomare Michele De Fazio Ramona Tiziana Giuliani Giorgio Catalano Filippa Cuccia General Surgery and Liver Transplantation Units Department of Emergency and Organ TransplantationUniversity of Bari "Aldo Moro"11-70124 BariItaly

The role of sphincteroplasty in the treatment of patients with fecal incontinence due to anal sphincter defects has been questioned because the success rate declines in the long-term.A new emerging treatment for fecal incontinence,sacral nerve stimulation,has been shown to be effective in these ***,the success rate of sphincteroplasty may depend of several patient-related and surgical-related factors and the outcome from sphincteroplasty has been evaluated differently(with qualitative data) from that after sacral nerve stimulation(quantitative data using scoring systems and quality of life).Furthermore,the data available so far on the longterm success rate after sacral nerve modulation do not differ substantially from those after *** actual data do not support the replacement of sphincteroplasty with sacral nerve stimulation in patients with fecal incontinence secondary to sphincter defects.

关键词： fecal incontinence Sacral nerve stimulation Sphincteroplasty

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

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World Journal of Gastroenterology 2007年第22期13卷 3101-3105页

作者： Marcel Cazemier Richelle JF Felt-Bersma Chris JJ Mulder Department of Gastroenterology and Hepatology VU University Medical Center Postbus 7057 1007 MB Amsterdam The Netherlands

AIM： To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation （RCI） in patients with fecal incontinence or constipation.METHODS： Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.RESULTS： Of the 201 patients （93 adults, 108 children）, 101 （50%） responded. Adults： anal plugs （8）, five stopped immediately, one stopped after 20 mo and two used it for 12-15 too. RCl （40, 28 fecal incontinence, 12 constipation）, 63% are still using it （mean 8.5 years）, 88% was satisfied. Younger adults （〈 40 years） were more satisfied with RCI （94 % vs 65%, P = 0.05）. Children： anal plugs （7）, 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI （26 fecal incontinence, 22 constipation）, 90% are still using it （mean time 6.8 years） and felt satisfied. Children tend to be more satisfied （P = 0.001）. Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.CONCLUSION： RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

关键词： fecal incontinence Constipation Retrograde colonic irrigation Anal plug

Outcomes and efficacy of magnetic resonance imaging-compatible sacral nerve stimulator for management of fecal incontinence: A multi-institutional study

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World Journal of Radiology 2024年第2期16卷 32-39页

作者： Binit Katuwal Amy Thorsen Kunal Kochar Ryba Bhullar Ray King Ernesto Raul Drelichman Vijay K Mittal Jasneet Singh Bhullar Department of Surgery Ascension Providence HospitalMichigan State University College of Human MedicineSouthfieldMI 48075United States Department of Colon and Rectal surgery Alina Health Abbott Northwestern HospitalMinneapolisMN 55407United States Colon and Rectal Surgery Advocate Illinois MasonicPark RidgeIL 60068United States Volunteer Student Department of ResearchAscension Providence HospitalSouthfieldMI 48075United States Colon and Rectal Surgery University of WisconsinMadisonWI 53715United States General and Colorectal Surgery Ascension Providence HospitalMichigan State University College of Human MedicineSouthfieldMI 48075United States Department of Surgery Department of Medical EducationAscension Providence HospitalMichigan State University College of Human MedicineSouthfieldMI 48075United States

BACKGROUND fecal incontinence(FI)is an involuntary passage of fecal matter which can have a significant impact on a patient’s quality of *** modalities of treatment exist for *** nerve stimulation is a well-established treatment for *** the increased need of magnetic resonance imaging(MRI)for diagnostics,the In-terStim which was previously used in sacral nerve stimulation was limited by MRI *** MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely *** To evaluate the efficacy,outcomes and complications of the MRI-compatible *** Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport,University of Minnesota,Advocate Lutheran General Hospital,and University of Wisconsin-Madison was pooled and *** demographics,clinical features,surgical techniques,complications,and outcomes were *** the Reporting of Observational studies in Epidemiology(STROBE)cross-sectional reporting guidelines were *** Seventy-three patients had the InterStim *** mean age was 63.29±12.2 ***-seven(78.1%)patients were females and forty-two(57.5%)patients had *** addition to incontinence,overlapping symptoms included diarrhea(23.3%),fecal urgency(58.9%),and urinary incontinence(28.8%).Fifteen(20.5%)patients underwent Peripheral Nerve Evaluation before proceeding to definite implant ***-two(43.8%)patients underwent rechargeable InterStim ***(4.1%)patients needed removal of the *** of the external lead connection was observed in 7(9.6%)patients after the stage I *** explanation for one patient was due to ***(9.6%)patients had other complications like nerve pain,hematoma,infection,lead fracture,and *** mean follow-up was 6.62±3.5 ***-eight(93.2%)patients reported significant improvement of symptoms on

关键词： fecal incontinence Sacral nerve stimulation InterStim Magnetic resonance imaging Sacral neuromodulation