title: Surgical management of fecal incontinence.
abstract: The surgical approach to treating fecal incontinence is complex. After optimal medical management has failed, surgery remains the best option for restoring function. Patient factors, such as prior surgery, anatomic derangements, and degree of incontinence, help inform the astute surgeon regarding the most appropriate option. Many varied approaches to surgical management are available, ranging from more conservative approaches, such as anal canal bulking agents and neuromodulation, to more aggressive approaches, including sphincter repair, anal cerclage techniques, and muscle transposition. Efficacy and morbidity of these approaches also range widely, and this article presents the data and operative considerations for these approaches.
authors.affiliation: Division of Colon and Rectal Surgery, Pennsylvania Hospital/Hospital of the University of Pennsylvania, University of Pennsylvania, 800 Walnut Street, 20th Floor, Philadelphia, PA 19106, USA. Electronic address: Joshua.bleier@uphs.upenn.edu.
authors.forename: Joshua I S
authors.initials: JI
authors.lastname: Bleier
authors.forename: Brian R
authors.initials: BR
authors.lastname: Kann
mesh_terms: D001003:Anal Canal / Q000601:surgery*; D001676:Biofeedback, Psychology; D017115:Catheter Ablation; D003113:Colonoscopy; D019841:Defecography; D004599:Electric Stimulation Therapy; D004576:Electromyography; D019160:Endosonography; D005242:Fecal Incontinence / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008160:Lumbosacral Plexus; D059346:Magnets; D009431:Neural Conduction; D019736:Prostheses and Implants; D060525:Pudendal Nerve; D013979:Tibial Nerve
keywords: Bulking agents; Fecal incontinence; Management; Sacral neuromodulation; Sphincter; Sphincteroplasty; Surgical