Faecal incontinence

Chatoor, D; Taylor, Stuart A.; Cohen, C. Richard G.; Emmanuel, Anton

doi:10.1002/bjs.5676

Cited by 62 publications

(56 citation statements)

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“…Many techniques to treat urinary incontinence have been adapted and applied to faecal incontinence: artificial sphincters, neuromodulation of the sacral nerves, and bulking agents. [19][20][21] The adaptation of these techniques require a detailed knowledge of the topographical relations between EAS, IAS and LAM. Our study confirms the intersphincteric location of the LAM, interposed between IAS and EAS, with mean thicknesses of 1.63 mm (LAM), 2.69 mm (IAS), and 2.95 mm (EAS).…”

Section: Discussionmentioning

confidence: 99%

Histo‐Topographic study of the longitudinal anal muscle

et al. 2008

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The longitudinal anal muscle (LAM) has been described as a vertical layer of muscular tissue interposed between the circular layers of the internal (IAS) and external (EAS) anal sphincters. There is, however, no general agreement in the literature on its composition and attachments. The aim of this study was to investigate the histological structure, attachments, and topography of the LAM in order to evaluate its role in continence and defecation, thus enhancing knowledge of the surgical anatomy of this region. After in situ formalin fixation, the pelvic viscera were removed from eight male and eight female cadavers (age range: 52–72 years). Serial macrosections of the bladder base, lower rectum and anal canal, cervix and pelvic floor complex, cut in the transverse (six specimens) and coronal (six specimens) planes, underwent histological and immunohistochemical studies. Four specimens were studied using the E12 sheet plastination technique. The LAM was identified in 10/12 specimens (83%). Transverse and coronal sections made clear that it is a longitudinal layer of muscular tissue, marking the boundary between the internal and external anal sphincters. From the anorectal junction it extends along the anal canal, receives fibers from the innermost part of the puborectalis and the puboanalis muscles, and terminates with seven to nine fibro‐elastic septa, which traverse the subcutaneous part of the external anal sphincter, reaching the perianal dermis. In the transverse plane, the mean thickness of the LAM was 1.68 ± 0.27 mm. Immunohistochemical staining showed that the LAM consists of predominantly outer striated muscle fibers and smaller numbers of inner smooth muscle fibers, respectively coming from the levator ani muscle and from the longitudinal muscular layer of the rectum. The oblique fibers suggest that the LAM may represent the intermediate longitudinal course of small bridging muscle bundles going reciprocally from the striated EAS to the smooth IAS and vice versa. The spatial result is the helical course of striated and smooth muscle fibers between the EAS and IAS, which contribute not only to the narrowing but also to some shortening of the anal canal during sphincter contraction. Thus, rather than being a boundary, the LAM gives anatomical evidence of a functional connection between two muscle systems with different structures and topography. Clin. Anat. 21:447–452, 2008. © 2008 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Histo‐Topographic study of the longitudinal anal muscle

et al. 2008

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“…Anal sphincter incompetence as well as UI can be related to pelvic floor dysfunction (25), and both should be treated concomitantly by surgical or non-surgical treatment, improving the patients' quality of life.…”

Section: Commentsmentioning

confidence: 99%

Prevalence and risk factors for urinary and fecal incontinence in brazilian women

et al. 2009

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Objective: To evaluate prevalence and risk factors of fecal and urinary incontinence (UI) in Brazilian women. Materials and Methods: 685 women older than 20 years of age answered a questionnaire about urinary and fecal symptoms, clinical and obstetric antecedents. They were grouped according to presence or absence of UI. Results: Urinary and fecal incontinence was reported in 27% and 2% of cases, respectively. Mean age of incontinent women was significantly higher than continent ones. Incontinent women had a mean number of micturitions significantly higher than the continent ones. On average, incontinent women had higher rate of pregnancies and vaginal delivery when compared to the continent ones. Body mass index (BMI) was significantly higher in incontinent participants and in women with no UI complaints (27.35 vs. 24.95, p < 0.05). Fecal incontinence prevalence was 2% and occurred exclusively in patients with UI. Conclusions: Vaginal delivery and high BMI have been identified as risk factors for UI development while aging and number of pregnancies may be correlated factors.

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“…There is a range of treatment options for such patients. A recent systematic review of faecal incontinence reported a trend favouring conservative management, using dietary modification, biofeedback and minimally invasive procedures, including sacral neuromodulation, the SECCA  Procedure (Curon Medical, Freemont, California, USA) and the use of injectable bulking agents 2 .…”

Section: Introductionmentioning

confidence: 99%