Present and Future in the Treatment of Fecal Incontinence

ABSTRACT

Treatment of fecal incontinence still remains a challenge to modern medicine due to many specific sides of this problem. The diversity of causes of fecal incontinence and different modes of action of the various treatment modalities mandate a tailored, individualized approach in each case. Surgery is the last treatment modality for patients suffering from severe fecal incontinence. Recent studies have shown poor late results after primary sphincter repair and low predictive value for most preoperative diagnostic tests. New surgical options such as artificial devices and electrically stimulated muscle transpositions are reported by acceptable success rates and unacceptably frequent complications. That is why current attention has focused on non- or minimally invasive therapies such as sacral nerve stimulation and temperature-controlled radio-frequency energy delivery to the anal canal. However, all these innovative techniques remain experimental untill enough high- evidence data are gathered for their objective evaluation.