[Anal incontinence].
Anal incontinence today is more frequent than current estimates indicate. When a patient seeks care for this condition, its cause and severity are assessed by a careful history and clinical examination. Two essential atraumatic examinations are decision-support tools: transrectal ultrasound and anal manometry. Treatment should always be proposed. Surgery is necessary in some cases: obvious rupture of the external sphincter, if possible confirmed by transrectal ultrasound, should be directly repaired. Should this treatment fail, a repeated repair or a sphincter replacement (graciloplasty or artificial sphincter) is called for. Neuromodulation therapy is often indicated in the absence of obvious rupture, especially in cases of pudendal neuropathy.
Faucheron
Jean-Luc
JL
Unité de chirurgie colorectale, Clinique universitaire de chirurgie digestive et de l'urgence, Hôpital Albert Michallon, F-38043 Grenoble cedex 9, France. JLFaucheron@chu-grenoble.fr
D001003:Anal Canal / Q000196:embryology / Q000293:injuries / Q000294:innervation / Q000601:surgery; D001187:Artificial Organs; D004599:Electric Stimulation Therapy / Q000379:methods; D005242:Fecal Incontinence / Q000145:classification / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005602:France / Q000453:epidemiology; D006801:Humans; D018482:Muscle, Skeletal / Q000637:transplantation; D015995:Prevalence; D012421:Rupture / Q000150:complications; D012720:Severity of Illness Index