Long-Term Outcomes of Anal Sphincter Repair for Fecal Incontinence

Abstract

Despite worsening results over time, most patients remain satisfied with their surgical outcome postsphincteroplasty. Efforts should be directed at identifying patients who may do poorly following sphincter repair, as well as establishing standardized long-term outcome benchmarks for comparing novel techniques for treating fecal incontinence.

Fistulotomy or fistulectomy and primary sphincteroplasty for anal fistula (FIPS): a systematic review

“…Several studies have shown that outcomes of delayed or immediate sphincteroplasty for fecal incontinence related to obstetric injury deteriorate over the time [50]. For this reason, most skepticism about FIPS regards at the results of longterm follow-up.…”

Current Management of Fecal Incontinence

“…Although the majority of patients find improvement shortly after recovery from the surgery, long-term worsening of symptoms can occur after sphincter repair, as evidenced by a systematic review of 16 studies with 900 patients. 19 Short-term loss of efficacy has been previously described in a study of 86 patients. 20 Forty-two (49%) of the patients had complete fecal continence after repair, but during a mean followup of 40 months, only 21 (28%) of the patients had perfect continence.…”

Advances in the Surgical Treatment of Faecal Incontinence

“…At a median follow up of 59 (30-72) months, ten of these patients became continent. The Cleveland Clinic Florida-FI score improved from 16 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) at baseline to 3 (0-7). Two of these devices were explanted due to infection following revisional surgery.…”

“…A recent systematic review has examined the long term outcome of this operation [20]. This reviewed the outcome of over 900 patients at five or more years of follow up.…”