Published in:
01-04-2017 | Technical Note
Technique of the transobturator puborectal sling in fecal incontinence
Published in: Techniques in Coloproctology | Issue 4/2017
Login to get accessAbstract
Background
The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years.
Methods
Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results.
Results
The median CCIS was significantly improved at 12 months (18.5 [15–20] vs 7.5 [4–20] in postoperative assessment; p = 0.037). The median FIQL was improved at 12 months (6.05 [5.6–7] vs 10.2 [5.6–12.5]; p = 0.0542). No adverse event was recorded except the distension of the device in one patient. Finally, at 5 years, 3 patients were improved, 1 had recurrence of FI symptoms (at 24 months) and 2 had no change.
Conclusion
This technique is a minimally invasive surgical treatment and constitutes a new therapeutic option for FI in case of failure of conventional treatment.