Novel surgical approaches to fecal incontinence: neurostimulation and artificial anal sphincter.
Neurostimulation, neosphincters with neurostimulation, and implanted artificial sphincters are recently developed therapeutic options for patients with end-stage fecal incontinence. Of these approaches, sacral nerve electric stimulation appears to be the most promising because of its relative simplicity and low morbidity. However, it is best suited for patients with anatomically intact sphincters. The other procedures target patients with gross structural defects in the sphincter but are still in their infancy. In this article we discuss these techniques and review their rationale, mechanisms of action, indications, outcomes, and complications.
Zhao
Xiaotuan
X
Division of Gastroenterology and Hepatology, University of Texas Medical Branch, 4.106 McCullough Building, 301 University Boulevard, Galveston TX 77555-0764, USA. jpasrich@utmb.edu
Pasricha
Pankaj J
PJ
D001003:Anal Canal / Q000503:physiopathology* / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000601:surgery*; D006801:Humans; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery*