PubMed · 7885896
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J Laycock. Continence. Must do better.. https://pubmed.ncbi.nlm.nih.gov/7885896/
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OBJECTIVE: To review our experience with vaginal sacrospinous colpopexy combined with perineorraphy performed for patients with genital prolapse who concomitantly suffered from faecal incontinence (FI). SETTING: Gynaecology Department, Benenden Hospital, Benenden, Kent, UK. SUBJECTS AND METHODS: Between January 1997 and December 2001, 16 patients presented with symptoms of genital prolapse and faecal incontinence. Eleven out of the 16 patients (69%) had anorectal physiological tests and endoanal ultrasound performed before surgery. All patients had sacrospinous colpopexy and perineorraphy. Simultaneous vaginal hysterectomy was performed in two patients and anterior colporrhaphy in six patients. RESULTS: The mean age was 60 years and median parity was 2. The mean operative time was 62 min (range 35-100) and the mean blood loss was 60 ml (range 30-160). The mean follow-up period was 37 months (6-65). Thirteen patients (81%) reported no faecal incontinence after surgery, and two patients (12.5%) reported improvement. One patient (6.5%) had no improvement in her symptom of faecal incontinence after surgery. None of the patients had recurrence of genital prolapse during follow up. CONCLUSION: Sacrospinous colpopexy combined with perineorraphy can help to cure symptoms of faecal incontinence associated with genital prolapse. The possible mechanisms for such a favourable result are discussed.
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Incontinence aids are mechanical devices that help reduce, capture, absorb or channel urinary and stool loss. They can exert a significant positive impact on the quality of life and the social integration of those affected, as well as provide relief to their care-givers. Incontinence aids are used as a bridge until conservative and operative treatments bring continence, as a complement to other therapies or as a long-term course of treatment. The selection of appropriate incontinence aids, such as vaginal pessaries, penis clamps, and tampons, urinals, urine and faecal collectors, absorbing aids, urethral and suprapubic catheter channelling systems--requires a great deal of experience and an extensive assortment of various products in different sizes. In order to provide the patient with optimal treatment and advice where not only the products available are changing rapidly, but the conditions and environment as well (e.g., insurance reimbursement), close-knit teamwork is required among the physician, incontinence nurse, and the care-providers. Likewise to be considered is the fact that incontinence aids and care requirements vary significantly among the specialties of urogynaecology, urology, paraplegic centres, paediatrics and nursing homes; specific competence centres are therefore required for these areas.