Current diagnosis and treatment algorithms for anal incontinence

BJU International

Volumn 98, Issue SUPPL. 1, 2006, Pages 97-106

  Rogers, Rebecca G ^a   Abed, Husam ^a   Fenner, Dee E ^b  

^a UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

Author keywords

Anal sphincter; Fecal incontinence; Quality of life

Indexed keywords

ADRENALIN; ANTIBIOTIC AGENT; ANTIDIARRHEAL AGENT; ATROPINE; ATROPINE PLUS DIPHENOXYLATE; BULKING AGENT; COLLAGEN; DIPHENOXYLATE; ENEMA; FAT; ISPAGULA; LAXATIVE; LOPERAMIDE; METHYLCELLULOSE; PHENYLEPINEPHRINE; POLITEF; SILICONE; UNCLASSIFIED DRUG; VALPROIC ACID; ZIRCONIUM OXIDE;

ABDOMINAL PAIN; ANORECTAL PRESSURE; BEHAVIOR THERAPY; COLOSTOMY; CONSTIPATION; DEFECOGRAPHY; DERMATITIS; DIAGNOSTIC TEST; DIARRHEA; DIET; DRUG INDUCED HEADACHE; ELECTROSTIMULATION; FECES INCONTINENCE; FEEDBACK SYSTEM; FLUID THERAPY; HORMONE SUBSTITUTION; HUMAN; NAUSEA; NERVE STIMULATION; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOPHYSIOLOGY; PHYSIOTHERAPY; PREVALENCE; PRIORITY JOURNAL; RADIOFREQUENCY ABLATION; REVIEW; RISK FACTOR; SPHINCTEROPLASTY; ULTRASOUND;

ANAL CANAL; FECAL INCONTINENCE; FEMALE; HUMANS; QUALITY OF LIFE;

EID: 33746740521     PISSN: 14644096     EISSN: 1464410X     Source Type: Journal    
DOI: 10.1111/j.1464-410X.2006.06307.x     Document Type: Review

References (98)

1. Norton C, Christianson I, Butler U et al. Anal incontinence. In Abrams, P, Cardozo, L, Khoury, S, Wein, A eds, Incontinence, 2nd edn. The International Consultation on Incontinence, 2001. Paris: Health Publications Ltd., 2002
2. Boreham MK, Richter HE, Kenton KS et al. Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol 2005; 192: 1637-42
3. Nelson R, Furner S, Jesudason V. Fecal incontinence in Wisconsin nursing homes: prevalence and associations. Dis Colon Rectum 1998; 41: 1226-9
4. Davis K, Kumar D. Posterior pelvic floor compartment disorders. Best Pract Res Clin Obstet Gynaecol 2005; 19: 941-58
5. Deutekom M, Dobben AC, Dijkgraaf MG, Terra MP, Stoker J, Bossuyt PM. Costs of outpatients with fecal incontinence. Scand J Gastroenterol 2005; 40: 552-8
6. Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI. Anal-sphincter disruption during vaginal delivery. N Engl J Med 1993; 329: 1905-11
7. Eason E, Labrecque M, Marcoux S, Mondor M. Anal incontinence after childbirth. CMAJ 2002; 166: 326-30
8. Handa VL, Danielson BH, Gilbert WM. Obstetric anal sphincter lacerations. Obstet Gynecol 2001; 98: 225-30
9. Zetterstrom J, Lopez A, Anzen B, Norman M, Holstrom B, Mellgren A. Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair. Obstet Gynecol 1999; 94: 21-8
10. Fitzpatrick M, Behan M, O'Connell PR, O'Herlihy C. A randomized clinical trial comparing primary overlap with approximation repair of third-degree obstetric tears. Am J Obstet Gynecol 2000; 183: 1220-4
11. Varma A, Gunn J, Gardiner A, Lindow SW, Duthie GS. Obstetric anal sphincter injury: prospective evaluation and incidence. Dis Colon Rectum 1999; 42: 1537-43
12. Fenner DE, Genberg B, Brahma P, Marek L, DeLancey JO. Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol 2003; 189: 1543-9
13. Pollack J, Nordenstam J, Brismar S, Lopez A, Altman D, Zetterstrom. J. Anal incontinence after vaginal delivery. a five-year prospective cohort study. Obstet Gynecol 2004; 104: 1397-402
14. Sultan AH, Kamm MA, Hudson CN, Bartram CI. Third degree obstetric anal sphincter tears: risk factors and outcomes of primary repair. BMJ 1994; 308: 887-91
15. Lal M, Mann C, Callender R, Radley S. Does cesarean delivery prevent anal incontinence? Obstet Gynecol 2003; 101: 305-12
16. van Brummen HJ, Bruinse HW, van de Pol G, Heintz AP, van der Vaart CH. Defecatory symptoms during and after the first pregnancy: prevalences and associated factors. Int Urogynecol J Pelvic Floor Dysfunct 2006; 17: 224-30
17. Muller C, Belyaev O, Deska T, Chromik A, Weyhe D, Uhl W. Fecal incontinence: an up-to-date critical overview of surgical treatment options. Langenbecks Arch Surg 2005; 390: 544-52
18. Hsu Y, Fenner DE, Weadock WJ, DeLancey JO. Magnetic resonance imaging and 3-dimensional analysis of external anal sphincter anatomy. Obstet Gynecol 2005; 106: 1259-65
19. Delancey JO, Toglia MR, Perucchini D. Internal and external anal sphincter anatomy as it relates to midline obstetric lacerations. Obstet Gynecol 1997; 90: 924-7
20. Tjandra JJ, Lim JF, Matzel K. Sacral nerve stimulation: an emerging treatment for faecal incontinence. ANZ J Surg 2004; 74: 1098-106
21. Baxter NN, Rothenberger DA, Lowry AC. Measuring fecal incontinence. Dis Colon Rectum 2003; 46: 1591-605
22. Leigh RJ, Turnberg LA. Faecal incontinence: the unvoiced symptom. Lancet 1982; 1: 1349-51
23. Minor PB Jr. Economic and personal impact of fecal and urinary incontinence. Gastroenterology 2004; 126: S14-22
24. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993; 36: 77-97
25. Casal E, San Ildefonso A, Carracedo R, Facal C, Sanchez JA. Artificial bowel sphincter in severe anal incontinence. Colorectal Dis 2004; 6: 180-4
26. Pescatori M, Anastasio G, Bottini C, Mentasti A. New grading system and scoring for anal incontinence. Evaluation of 335 patients. Dis Colon Rectum 1992; 35: 482-7
27. Vaizey CJ, Carapeti E, Cahill JA, Kamm MA. Prospective comparison of faecal incontinencne grading systems. Gut 1999; 44: 77-80
28. Rockwood TH, Church JM, Fleshman JW et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 1999; 42: 1525-31
29. Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 2005; 193: 103-13
30. Rockwood TH, Church JM, Fleshman JW et al. Fecal incontinence quality of life scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 2000; 43: 9-16
31. Bug GJ, Kiff ES, Hosker G. A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG 2001; 108: 1057-67
32. Kwon S, Visco AG, Fitzgerald MP, Ye W, Whitehead WE; Pelvic Floor Disorders Network (PFDN). Validity and reliability of the Modified Manchester Health questionnaire in assessing patients with fecal incontinence. Dis Colon Rectum 2005; 48: 323-34
33. Hallan RI, Marzouk DE, Waldron DJ, Womack NR, Willliams NS. Comparison of digital and manometric assessment of anal sphincter function. Br J Surg 1989; 76: 973-5
34. Keating JP, Stewart PJ, Eyers AA, Warner D, Bokey EL. Are special investigations of value in the management of patients with fecal incontinence? Dis Colon Rectum 1997; 40: 896-901
35. Brink CA, Wells TJ, Sampselle CM, Taillie ER, Mayer R. A digital test for pelvic floor muscle strength in women with urinary incontinence. Nurs Res 1994; 43: 352-6
36. Rotholtz NA, Wexner SD. Surgical treatment of constipation and fecal incontinence. Gastroenterol Clin North Am 2001; 30: 131-66
37. Beets-Tan RG, Morren GI, Beets GL et al. Measurement of anal sphincter muscles: endoanal US, endoanal MRI or phased-array MR imaging? A study with health volunteers. Radiology 2001; 220: 81-9
38. Falk PM, Blatchford GJ, Cali RL, Christensen MA, Thorson AG. Transanal ultrasound and manometry in the evaluation of fecal incontinence. Dis Colon Rectum 1994; 37: 468-72
39. Burnett SJ, Speakman CT, Kamm MA, Bartram CI. Confirmation of endosonographic detection of external anal sphincter defects by simultaneous electromyographic mapping. Br J Surg 1991; 78: 448-50
40. Rociu E, Stoker J, Eijkemans MJ, Schouten WR, Lameris JS. Fecal incontinence: endoanal US versus endoanal MR imaging. Radiology 1999; 212: 453-8
41. Deen KI, Kumar D, Williams JG, Olliff J, Keighley MR. Anal sphincter defects. Correlation between endoanal ultrasound and surgery. Ann Surg 1993; 218: 201-5
42. Meyenberger C, Bertschinger P, Zala GF, Buchmann P. Anal sphincter defects in fecal incontinence: correlation between endosonography and surgery. Endoscopy 1996; 28: 217-24
43. Kleinubing H Jr, Jannini JF, Malafaia O, Brenner S, Pinho TM. Transperineal ultrasonography: a new method to image the anorectal region. Dis Colon Rectum 2000; 43: 1572-4
44. Dietz HP, Lanzarone V. Levator trauma after vaginal delivery. Obstet Gynecol 2005; 106: 707-12
45. Dietz HP, Shek C, Clarke B. Biometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol 2005; 25: 580-5
46. Dobben AC, Wiersma TG, Janssen LW et al. Prospective assessment of interobserver agreement for defecography in fecal incontinence. AJR Am J Roentgenol 2005; 185: 1166-72
47. Azpiroz F, Enck P, Whitehead WE. Anorectal functional testing: review of collective experience. Am J Gastroenterol 2002; 97: 232-40
48. Rao SS, Azpiroz F, Diamante N, Enck P, Tougas G, Wald A. Minimum standards of anorectal monometry. Neurogasteroenterol Motil 2002; 14: 553-9
49. Chen AS, Luchtefeld MA, Senagore AJ, MacKeigan JM, Hoyt C. Pudendal nerve latency. Does it predict outcome of anal sphincter repair? Dis Colon Rectum 1998; 41: 1005-9
50. Cheetham M, Brazzelli M, Norton C, Glazener CM. Drug treatment for faecal incontinence in adults. Cochrane Database of Syst Rev2003;3: CD002116 10.1002/, 14651858.CD002116
51. Donnelly V, O'Connell PR, O'Herlihy C. The influence of oestrogen replacement on faecal incontinence in postmenopausal women. Br J Obstet Gynaecol 1997; 104: 311-5
52. Berghmans LC, Hendriks HJ, Bo K, Hay-Smith EJ, de Bie RA, van Waalwijk van Doorn ES. Conservative treatment of stress urinary incontinence in women: a systematic review of randomized clinical trials. Br J Urol 1998; 82: 181-91
53. Norton C, Hosker G, Brazzelli M. Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Cochrane Database Syst Rev 2000; 2: CD002111
54. Martinez-Puente Mdel C, Pascual-Montero JA, Garcia-Olmo D. Customized biofeedback therapy improves results in fecal incontinence. Int J Colorectal Dis 2004; 19: 210-4
55. Dobben AC, Terra MP, Berghmans B et al. Functional changes after physiotherapy in fecal incontinence. Int J Colorectal Dis 2005 (Epub ahead of print) DOI: 10.1007/s00384-005-0049-6
56. Ozturk R, Niazi S, Stessman M, Rao SS. Long-term outcome and objective changes of anorectal function after biofeedback therapy for faecal incontinence. Aliment Pharmacol Ther 2004; 20: 667-74
57. Norton C, Chelvanayagam S, Wilson-Barnett J, Redfern S, Kamm MA. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology 2003; 125: 1320-9
58. Solomon MJ, Pager CK, Rex J, Roberts R, Manning J. Randomized, controlled trial of biofeedback with anal manometry, transanal ultrasound, or pelvic floor retraining with digital guidance alone in the treatment of mild to moderate fecal incontinence. Dis Colon Rectum 2003; 46: 703-10
59. Norton C, Gibbs A, Kamm MA. Randomized, controlled trial of anal electrical stimulation for fecal incontinence. Dis Colon Rectum 2006; 49: 190-6
60. Fynes MM, Marshall K, Cassidy M et al. A prospective, randomized study comparing the effect of augmented biofeedback with sensory biofeedback alone on fecal incontinence after obstetric trauma. Dis Colon Rectum 1999; 42: 753-61
61. Mahony RT, Malone PA, Nalty J, Behan M, O'Connell PR, O'Herlihy C. Randomized clinical trial of intra-anal electromyographic biofeedback physiotherapy with intra-anal electromyographic biofeedback augmented with electrical stimulation of the anal sphincter in the early treatment of postpartum fecal incontinence. Am J Obstet Gynecol 2004; 191: 885-90
62. Matzel KE, Stadelmaier U, Hohenfellner M, Gall FP. Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet 1995; 346: 1124-7
63. Matzel KE, Stadelmaier U, Hohenberger W. Innovations in fecal incontinence: sacral nerve stimulation. Dis Colon Rectum 2004; 47: 1720-8
64. Leroi AM, Parc Y, Lehur PA et al. Efficacy of sacral nerve stimulation for fecal incontinence: results of a multicenter double-blind crossover study. Ann Surg 2005; 242: 662-9
65. Jarrett ME, Varma JS, Duthie GS, Nicholls RJ, Kamm MA. Sacral nerve stimulation for faecal incontinence in the UK. Br J Surg 2004; 91: 755-61
66. Kenefick NJ, Christiansen J. A review of sacral nerve stimulation for the treatment of faecal incontinence. Colorectal Dis 2004; 6: 75-80
67. Hosker G, Norton C, Brazzelli M. Electrical stimulation for faecal incontinence in adults. Cochrane Database Syst Rev 2000; 2: CD001310
68. Pfrommer W, Holschneider AM, Loffler N, Schuff B, Ure BM. A new polyurethane anal plug in the treatment of incontinence after anal atresia repair. Eur J Pediatr Surg 2000; 10: 186-90
69. Deutekom M, Dobben A. Plugs for containing faecal incontinence. Cochrane Database Syst Rev2005;3: CD005086. DOI: 10.1002/14651858.CD005086.pub2
70. Parks AG. Royal Society of Medicine, Section of Proctology; Meeting 27 November 1974. President's Address. Anorectal incontinence. Proc R Soc Med 1975; 68: 681-90
71. Malouf AJ, Norton CS, Engel AF, Nicholls RJ, Kamm MA. Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet 2000; 355: 260-5
72. Karoui S, Leroi AM, Koning E, Menard JF, Michot F, Denis P. Results of sphincteroplasty in 86 patients with anal incontinence. Dis Colon Rectum 2000; 43: 813-20
73. Halverson AL, Hull TL. Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 2002; 45: 345-8
74. Bravo Gutierrez A, Madoff RD, Lowry AC, Parker SC, Buie WD, Baxter NN. Long-term results of anterior sphincteroplasty. Dis Colon Rectum 2004; 47: 727-31
75. Barisic GI, Krivokapic ZV, Markovic VA, Popovic MA. Outcome of overlapping anal sphincter repair after 3 months and after a mean of 80 months. Int J Colorectal Dis 2006; 21: 52-6
76. Garcia V, Rogers RG, Kim SS, Hall RJ, Kammerer-Doak DN. Primary repair of obstetric anal sphincter laceration: a randomized trial of two surgical techniques. Am J Obstet Gynecol 2005; 192: 1697-701
77. Tjandra JJ, Han WR, Goh J, Carey M, Dwyer P. Direct repair vs. overlapping sphincter repair: a randomized, controlled trial. Dis Colon Rectum 2003; 46: 937-43
78. Tan M, O'Hanlon DM, Cassidy M, O'Connell PR. Advantages of a posterior fourchette incision in anal sphincter repair. Dis Colon Rectum 2001; 44: 1624-9
79. Kammerer-Doak DN, Wesol AB, Rogers RG, Dominquez CE, Dorin MH. A prospective cohort study of women after primary repair of obstetric anal sphincter laceration. Am J Obstet Gynecol 1999; 181: 1317-23
80. Grant A. The choice of suture materials and techniques for the repair of perineal trauma: an overview of the evidence from controlled trials. Br J Obstet Gynaecol 1989; 96: 1281-9
81. Mackrodt C, Gordon B, Fern E, Ayers S, Truesdale A, Grant A. The Ipswich Childbirth Study: 2. A randomized comparison of polyglactin 910 with chromic catgut for postpartum perineal repair. Br J Obstet Gynaecol 1998; 105: 441-5
82. Mahomed K, Grant A, Ashurst H, James D. The Southmead perineal suture study. A randomized comparison of suture materials and suturing techniques for repair of perineal trauma. Br J Obstet Gynaecol 1989; 96: 1272-80
83. Guenaga K, Matos D, Castro AA, Atallah AN, DM Wille-Jørgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev2005;1: CD001544. DOI: 10.1002/14651858.CD001544.pub2
84. Nessim A Wexner SD Agachan F et al. Is bowel confinement necessary after anorectal reconstructive surgery? A prospective, randomized, surgeon-blinded trial. Dis Colon Rectum 1999; 42: 16-23
85. Williams NS, Patel J, George BD, Hallan RI, Watkins ES. Development of an electrically stimulated neoanal sphincter. Lancet 1991; 338: 1166-9
86. Baeten CG, Konsten J, Spaans F et al. Dynamic graciloplasty for treatment of faecal incontinence. Lancet 1991; 338: 1163-5
87. Baeten CG, Bailey HR, Bakka A et al. Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum 2000; 43: 743-51
88. Koch SM, Uludag O, Rongen MJ, Baeten CG, van Gemert W. Dynamic graciloplasty in patients born with an anorectal malformation. Dis Colon Rectum 2004; 47: 1711-9
89. Christiansen J, Rasmussen OO, Lindorff-Larsen K. Long-term results of artificial anal sphincter implantation for severe anal incontinence. Ann Surg 1999; 230: 45-8
90. Devesa JM, Rey A, Hervas PL et al. Artificial anal sphincter: complications and functional results of a large personal series. Dis Colon Rectum 2002; 45: 1154-63
91. Mundy L, Merlin TL, Maddern GJ, Hiller JE. Systematic review of safety and effectiveness of an artificial bowel sphincter for faecal incontinence. Br J Surg 2004; 91: 665-72
92. Shafik A. Polytetrafluoroethylene injection for the treatment of partial fecal incontinence. Int Surg 1993; 78: 159-61
93. Kenefick NJ, Vaizey CJ, Malouf AJ, Norton CS, Marshall M, Kamm MA. Injectable silicone biomaterial for faecal incontinence due to internal anal sphincter dysfunction. Gut 2002; 51: 225-8
94. Davis K, Kumar D, Poloniecki J. Preliminary evaluation of an injectable anal sphincter bulking agent (Durasphere) in the management of faecal incontinence. Aliment Pharmacol Ther 2003; 18: 237-43
95. Tjandra JJ, Lim JF, Hiscock R, Rajendra P. Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction is effective. Dis Colon Rectum 2004; 47: 2138-46
96. Efron JE. The SECCA procedure: a new therapy for treatment of fecal incontinence. Surg Technol Int 2004; 13: 107-10
97. Takahashi T, Garcia-Osogobio S, Valdovinos MA, Belmonte C, Barreto C, Velasco L. Extended two-year results of radio-frequency energy delivery for the treatment of fecal incontinence (the Secca procedure). Dis Colon Rectum 2003; 46: 711-5
98. Norton C, Burch J, Kamm MA. Patients' views of a colostomy for fecal incontinence. Dis Colon Rectum 2005; 48: 1062-9