title: Neurostimulation for fecal incontinence after correction of repair of imperforate anus.
abstract: We are reporting the case of a 32-year-old female who had suffered from fecal incontinence (FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.
authors.affiliation: Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Ghislain Devroede, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bougie
authors.affiliation: Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Ghislain Devroede, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: McFadden
authors.affiliation: Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Ghislain Devroede, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mayer
authors.affiliation: Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Ghislain Devroede, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Lebel
authors.affiliation: Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Ghislain Devroede, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
authors.forename: Ghislain
authors.initials: G
authors.lastname: Devroede
keywords: Congenital malformation; Fecal incontinence; Imperforate anus; Neuromodulation; Neurostimulation