Long-term results after fecal incontinence surgery

Abstract

Surgery has been a mainstay of incontinence treatment in selected cases since more than 30 years. However, surgery has never been compared directly to conservative treatment forms such as medical treatment, pelvic floor exercises or biofeedback training. Further, most procedures employed have never been compared in a randomized way and with adequate patient numbers. The number of patients treated surgically for fecal incontinence and described retrospectively surpasses 10,000, but only 110 patients have been included in four trials that prospectively randomized surgical treatment. This small number of relevant trials with small sample sizes and other methodological weaknesses made it impossible to identify or refute important differences between different surgical procedures (Malouf et al. 2001; Bachoo et al. 2003).