[Incontinence after ileo-anal pouch anastomosis--diagnostic criteria and therapeutic sequelae].
After ileo-pouch-anal anastomosis (IPAA) there is an increased risk of incontinence due to intraoperative damage of the anal sphincter. We present a new concept to identify a potential incontinence prior to the closure of ileostomy by clinical and anal manometrical examinations. In 11 of 121 (9.1%) patients we diagnosed a potential incontinence. By biofeedback training we could achieve in this way a sufficient continence after the closure of ileostomy. After an average of 5.0 +/- 4.3 months of training rest pressures improved from 19.3 +/- 2.1 mmHg to 33.0 +/- 3.5 mmHg and squeeze pressures from 60.5 +/- 27.7 mmHg to 93.5 +/- 17.3 mmHg. Prior to IPAA patients with potential incontinence show significantly reduced rest pressures of 51.0 +/- 18.4 mmHg.
Kroesen
A J
AJ
Chirurgische Klinik und Poliklinik, Universität Heidelberg.
Stern
J
J
Buhr
H J
HJ
Herfarth
C
C
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000328:Adult; D001676:Biofeedback, Psychology / Q000295:instrumentation; D003093:Colitis, Ulcerative / Q000601:surgery*; D005242:Fecal Incontinence / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods; D008297:Male; D008365:Manometry / Q000295:instrumentation; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation
Kontinenzstörungen nach ileoanaler Pouchanlage--diagnostische Kriterien und therapeutische Folgerungen.