Fecal incontinence. What to do?.

Abstract

There are various functional or organic pathologies that can interfere with the defecation mechanism. The authors present 4 clinical cases with fecal incontinence: 1 false enconprese--2 myelomeningoceles--1 ileo-anal anastomose (total colectomy in Behçet disease). All cases were evaluated manometrically and operated with myorrhaphy of the rectum levators, plasty of gluteus muscles with approximation and median suture, (without rectum circumferential dissection), associating contiguous muscles of independent enervation. In incontinence due to ileo-anal anastomose, a prior ileostomy was made and an S ileal anal-pouch reconstructed. In other cases any intestinal derivation was made. In 3 cases, post operation treatment went well without incidents and there was a clear improvement in the continence. In the other case (myelomeningocele) a complication developed-an abscess with suture dehiscence-which most likely contributed to a less satisfactory result. After the incontinence cases being entirely studied the technique followed is easy to use, adopting neighboring muscular groups capable of improving the continence mechanism.