What Surgical Procedures Are Used to Treat Bowel Incontinence?
Surgical options for bowel incontinence include:
Sphincteroplasty. Rectal sphincter repair is the most common procedure used to correct a defect in the sphincter muscles. There are two anal muscles that control bowel movements, similar to two round doughnuts, one inside the other. If a defect exists in the complete circle of muscle, the problem can be corrected with this surgery. During the sphincteroplasty, the two ends of the muscle are cut and overlapped onto one another, then sewn in place to restore the complete circle of muscle.
Muscle transposition. During this procedure gluteal (buttock) or gracilis (inner thigh) muscles are used to encircle and strengthen the anal canal. When the inner thigh muscle is used, pacemaker-like electrodes are implanted into the grafted muscle to train it to remain contracted. When the buttock muscle is used, the lower portion of this muscle is freed from the tailbone region and wrapped around the anus to construct a new anus. The buttock muscle transposition does not require the use of a pacemaker. This procedure is an option for the small percentage of patients whose condition cannot be successfully treated with sphincteroplasty.
Colostomy. In rare and very difficult cases, the only alternative may be a (colostomy, a surgically created opening in the abdominal wall through which the colon passes, and where a bag is fitted to collect stool.
If conservative treatment or surgical repair of the anal sphincter fails to improve a patient's situation, an artificial bowel sphincter may be an option. The Acticon Neosphincter is a circular device implanted around the anus. The device can be inflated like a balloon to prevent the passage of stool. When a person has to move the bowels, the plastic ring can be deflated for stool to pass through.
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