Dr Dr Vicente Pla Martí and colleagues from Spain evaluated the results of surgery in the treatment of fecal incontinence of obstetric origin.
The research team assessed the effect of treatment on the quality of life of these patients.
The team studied a consecutive series of 43 patients, who had undergone surgery for severe fecal incontinence of obstetric aetiology between 1990 and 2004.
The researchers carried out clinical evaluation, anorectal manometry, anal endosonography, and measurement of the pudendal nerve terminal motor latency.
The degree of incontinence, both preoperative and at the end of follow-up was evaluated using the Cleveland Clinic Score.
The researchers assessed quality of life using the Fecal Incontinence Quality of Life Scale.
The team completed an assessment on 35 of the 43 patients.
The mean age in the series was 53 years.
After an average follow-up of 50 months, the researchers noted that the mean Cleveland Clinic Score had reduced significantly, passing from 16 to 6.
Pudendal neuropathy was found to be a factor of poor prognosis.
The results of the quality of life questionnaire at the end of follow-up for lifestyle was 3.5, and 3.1 for coping or behavior.
The researchers noted that the quality of life questionnaire for depression or self perception was 3.7, and 3.3 for embarrassment.
The team observed a statistically significant linear relationship between incontinence measured on the Cleveland Clinic Score and quality of life.
The team obtained a preoperative questionnaire from 14 patients undergoing surgery since the publication of the Fecal Incontinence Quality of Life Scale questionnaire.
The research team found a significant improvement on each of the 4 scales, including lifestyle, coping and behaviour, depression, and embarrassment.
Dr Pla Martí's team concludes, “Surgical treatment of fecal incontinence of obstetric origin achieves good results in a high percentage of patients and has a positive effect on their quality of life.”
“The existence of prolonged preoperative pudendal nerve motor latency indicates a poor prognosis.”