Results of Parks operation for faecal incontinence after anal sphincter injury.

Browning, G. G. P.; Motson, R. W.

doi:10.1136/bmj.286.6381.1873

Cited by 52 publications

(13 citation statements)

References 7 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If an internal anal sphincter defect is identified, a separate imbrication of the internal anal sphincter may be undertaken. Symptom improvement in the range of 70-80% has been reported (192,193), although one study reported a lower improvement rate (194). In patients with incontinence due to a weak, but intact anal sphincter, postanal repair has been tried (195).…”

Section: Specific Treatmentmentioning

confidence: 99%

Diagnosis and Management of Fecal Incontinence

Rao

2004

Am J Gastroenterology

284

295

View full text Add to dashboard Cite

DEFINITIONFecal incontinence is defined as either the involuntary passage or the inability to control the discharge of fecal matter through the anus. Clinically there are three subtypes (a) passive incontinence-the involuntary discharge of stool or gas without awareness; (b) urge incontinence-the discharge of fecal matter in spite of active attempts to retain bowel contents, and (c) fecal seepage-the leakage of stool following otherwise normal evacuation. The severity of incontinence can range from the unintentional elimination of flatus to the seepage of liquid fecal matter or sometimes the complete evacuation of bowel contents. Not surprisingly, these events cause considerable embarrassment, which in turn can lead to a loss of self-esteem, social isolation, and a diminished quality of life (1). EPIDEMIOLOGYAlthough fecal incontinence affects people of all ages, its prevalence is disproportionally higher in women, in the elderly, and in nursing home residents. Estimates of its prevalence vary greatly and depend on the clinical setting, the influence of social stigma, the definition of incontinence, and the frequency of occurrence.In the U.S. householder survey, frequent leakage of stool or fecal staining for more than 1 month was reported by 7.1% and 0.7% of the population, respectively (2). In contrast, two or more episodes of fecal incontinence per month were reported by 0.8% of patients presenting to primary care clinics in the UK (3). In an elderly (>65 yr) self-caring population, fecal incontinence occurred at least once a week in 3.7% of subjects and in more men than women (men:women = 1.5:1) (4). In contrast, 25-35% of institutionalized patients (5) and 10-25% of hospitalized geriatric patients (6) suffer from fecal incontinence. In the United States, fecal incontinence is the second leading cause for placement in nursing homes (6).In a survey of 2,570 households, comprising 6,959 individuals, the prevalence of at least one episode of incontinence during the previous year was 2.2%; among these 63% were women, 30% were >65 yr of age, 36% were incontinent of solid stool, 54% of liquid stool, and 60% of flatus (7). Furthermore, in another prospective survey of patients attending either a gastroenterology or a primary care clinic, over 18% reported fecal incontinence at least once a week (8). Only one third had ever discussed the problem with a physician (8). When stratified for the frequency of episodes, 2.7% of patients reported daily incontinence, 4.5% weekly, and 7.1% once per month (8). In another survey, fecal incontinence was associated with urinary incontinence in 26% of women attending a Uro/Gyn Clinic (9). A higher incidence of mixed fecal and urinary incontinence was also reported in nursing home residents (10, 11).The cost of health care related to fecal incontinence includes items that can be measured such as the evaluation, diagnosis and treatment of incontinence, medications, the use of disposable pads and other ancillary devices, skin care, and nursing care. Approximately $400 million/year we...

show abstract

Section: Specific Treatmentmentioning

confidence: 99%

Diagnosis and Management of Fecal Incontinence

Rao

2004

Am J Gastroenterology

284

295

View full text Add to dashboard Cite

show abstract

“…In der Literatur wurden zahlreiche operative Methoden rekonstruktiver Chirurgie der Schließmuskula-tur beschrieben. Dabei kommen die meisten Arbeiten zu dem Schluss, die neurogene Vorschädigung des Muskels habe einen signifikanten Einfluss auf das postoperative Ergebnis [6]. Wenige Arbeiten beschäftigen sich jedoch mit der Frage, wie sich die neurogene Schädigung quantitativ auf das postoperative Ergebnis auswirkt.…”

Section: Diskussionunclassified

Ergebnisse der Sphinkterrekonstruktion nach Parks: Welchen Einfluss haben der Grad der neurogenen Sch�digung und die muskul�re Defektgr��e?

Weyand¹,

Kempkes

Houf³

2003

Colo-Proctology

View full text Add to dashboard Cite

ZusammenfassungHintergrund: Ergebnisse der Sphinkterrekonstruktion nach Parks und der Einfluss der Faktoren neurogener Schaden und Defektgröße auf das postoperative Ergebnis. Patienten und Methoden:In einer retrospektiven Analyse untersuchten wir klinische und elektromyographische Parameter bei 142 in unserer Klinik durch eine Parks'sche Rekonstruktion versorgten Patienten mit traumatischer analer Inkontinenz zweiten bis dritten Grades.Ergebnisse: Bei 82% der Patienten konnte eine vollständige Kontinenz oder Minor Incontinence erreicht werden (51% vollkontinent, 31% erstgradig inkontinent). Die Defektgröße zeigte eine lineare Beziehung zum postoperativen Ergebnis. Ein schwerer neurogener Schaden ging mit schlechten funktionellen Ergebnissen einher. Wir zeigen eine neue, quantifizierende elektromyographische Einteilung.Schlussfolgerung: Sphinkterdefektgröße und Grad des neurogenen Schadens sind wichtige prognostische Faktoren der postoperativen funktionellen Situation. Die von uns entwickelte Einteilung der elektromyographischen Befunde erlaubt eine präzi-sere Beurteilung und Prognose des postoperativen Ergebnisses. AbstractBackground: Results of sphincter reconstruction according to Parks and the influence of the degree of neurogene damage and muscular defect on postoperative outcome.

show abstract

“…However, adequate muscle mass must be present for these operations to be successful [ 15]. Full continence was achieved after anal sphincter repair in 66-96% of cases with fecal incontinence [7,16] and after postnatal repair in 72% [17], Gracilis muscle transposition can be advised when sphincter muscle has been lost [6,18], There is no large series reporting on the results of this operation; there have been scattered successful reports [19], However, the operation is more time consuming and complicated than puborectoplasty, although the two procedures have the same indication of loss of the sphincteric mass.…”

Section: Discussionmentioning

confidence: 99%

Piborectoplasty: New Technique for the Repair of Fecal Incontinence

Shafik¹

1991

Dig Surg

View full text Add to dashboard Cite

A new technique for the treatment of fecal incontinence is presented. It was practiced in 31 patients with incontinence of formed stools. Incontinence was idiopathic in 21 patients and traumatic with excessive loss of sphincteric muscle in 10. Manometric and electromyographic studies were performed before and after the operation. The procedure comprises the fashioning of a curvilinear incision between rectal neck orifice and coccyx. The supralevator region is entered. A Teflon sling 20 × 2 cm is sutured at its middle to upper part of the rectal neck (anal canal). The 2 limbs of the sling are then withdrawn forward through 2 incisions on both pubic rami and are sutured to the pubic bone. Good results have been achieved in 83.8%. The continent effect of the operation is related to increase of rectal neck pressure and possible rectal neck elongation. The operation is indicated in fecal incontinence, particularly of the idiopathic type and traumatic injuries with excessive sphincteric loss. It is simple, easy and was done under no cover of colostomy.

show abstract

Results of Parks operation for faecal incontinence after anal sphincter injury.

Cited by 52 publications

References 7 publications

Diagnosis and Management of Fecal Incontinence

Diagnosis and Management of Fecal Incontinence

Ergebnisse der Sphinkterrekonstruktion nach Parks: Welchen Einfluss haben der Grad der neurogenen Sch�digung und die muskul�re Defektgr��e?

Piborectoplasty: New Technique for the Repair of Fecal Incontinence

Contact Info

Product

Resources

About