Results of sphincteroplasty performed for the patients with a fecal incontinence caused by sphincter damage

Mantas Vilčinskas¹, Justinas Vencius¹, Jovita Fultinavičiūtė¹, Gabrielė Ivanovaitė¹, Vytautas Juzėnas¹, Saulius Švagždys²

¹Lithuanian University of Health Sciences, Faculty of Medicine

²Clinic of Surgery, Hospital of Lithuanian University of Health Sciences Kauno klinikos

 

  ABSTRACT Fecal Incontinence is one of the most intractable conditions in coloproctology, which leads not only to physical, but also to psychological problems, social isolation and deterioration in the quality of life.^[1] Surgery takes an important place in the treatment of fecal incontinence; however, it is associated with a large number of relapses and complications.^[2] Sphincteroplasty is an operation which is performed to patients suffering from mild to severe fecal incontinence, when there is an anatomical violation of sphincter.^[3] Aim: To evaluate the outcomes after sphincteroplasty in patients with fecal incontinence caused by sphincter defect. Tasks:

1. To evaluate and compare the quality of life changes before and after the sphincteroplasty.
2. To evaluate and compare the changes in fecal incontinence before and after sphincteroplasty.

Methodology: The object of the research was patients who have undergone sphincteroplasty for fecal incontinence during 2011-2014 in Hospital of Lithuanian University of Health Sciences Kauno klinikos, Clinic of Surgery. Fecal incontinence severity (Wexner) and quality of life (QOL) evaluation scales, which were used to assess impact of fecal incontinence on subject’s lifestyle, behavior, self-esteem and feeling of shame, were sent to 22 patients. Participants’ received two copies of each scale – to assess the condition before and after surgery. Results: Nine responses were received from the patients. Average age of the patients is 57.5 ± 13.6 years. All subjects were women. QOL scale is set by “I feel I have no control over my bowels” (p<0.05). In calculating the average grades in QOL scale a lifestyle improvement was monitored (from 7:56 to 11:44), behavior (from 7.78 to 22.11), self-esteem increased (from 8.22 to 10.78) and stigma reduction (from 7.61 to 11:39), but the changes are not statistically significant (p>0.05). Wexner scale is set by “Leakage of Solid Stool” and “Scale score” (p<0.05). Comparing other variables between the two groups a statistically significant difference (p>0.05) was not found. Conclusions: 1. Statistically significant lifestyle, behavior, self-esteem, feeling of shame changes after sphincteroplasty were not observed (p>0.05). 2. A statistically significant change in fecal incontinence was found. Subjects that undergone sphincteroplasty are significantly less plagued by the solid fecal incontinence (p<0.05).