Outcome of sphincteroplasty combined with surgery for urinary incontinence and pelvic organ prolapse.
OBJECTIVE
This is the first reported prospective study comparing outcome and cost in patients undergoing sphincteroplasty for anal incontinence vs. sphincteroplasty performed in combination with one or more procedures for urinary incontinence and/or pelvic organ prolapse.


METHODS
We analyzed 44 patients with fecal incontinence who underwent anal sphincter repair alone (20 patients) or in combination with procedures for urinary incontinence or pelvic organ prolapse (24 patients). Information regarding risk factors for fecal incontinence, the degree of incontinence, and the extent that incontinence limited social, physical, and sexual activity was prospectively obtained from questionnaires. Clinic chart reviews and follow-up telephone interviews provided additional data. A cohort of case-matched patients who underwent only urogynecologic procedures was compared retrospectively for operative time, hospital cost, length of stay, and postoperative complications.


RESULTS
There were no major complications in any group. The functional outcomes, physical, social, and sexual activity were similar in all three groups. Twenty-two of 24 patients who underwent the combined procedures were glad that they had both procedures concomitantly.


CONCLUSIONS
Combination pelvic floor surgery provides good outcomes and is cost effective. This approach should be offered to women with concurrent problems of fecal and urinary incontinence and/or pelvic organ prolapse.
Halverson
A L
AL
Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Hull
T L
TL
Paraiso
M F
MF
Floruta
C
C
D001003:Anal Canal / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000191:economics / Q000379:methods; D005242:Fecal Incontinence / Q000150:complications / Q000601:surgery*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D014549:Urinary Incontinence / Q000150:complications / Q000601:surgery*; D013519:Urogenital Surgical Procedures / Q000191:economics / Q000379:methods; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*