Fecal Incontinence (eBook)

CARLO RATTO. He was born in Neaples, July 6th, 1962. He was graduated in Medicine and Surgery at the Catholic University of Rome in 1987. Specialist in General Surgery. He is Researcher at the Department of Clinica Chirurgica, Catholic University, Rome. His clinical practice, at the Division of Chirurgia Digestiva, Department of Surgical Sciences of Catholic University, Rome (Policlinico "A. Gemelli"), concerns particularly the colo-recto-anal diseases. He is actively involved in research on: Colorectal cancer, in particular concerning diffusion modalities of the tumor and prognosis, integrated therapies (surgery, chemoradiation, intraoperative radiation therapy), molecular biology; Anal cancer, in particular concerning staging and restaging of the tumor, integrated therapies (chemoradiation); Anorectal physiology, in particular concerning anorectal manometry, electrophysiology studies, endoanal ultrasound in benign anorectal disorders; Fecal incontinence and constipation, in particular concerning, pathophysiology and treatment with traditional and novel therapeutic modalities (sphincteroplasty, dynamic graciloplasty, sacral neuromodulation); Fistula-in-ano, in particular concerning the assessment of fistula and abscess with endoanal ultrasound related to surgery results; Rectocele, in particular, concerning pathophysiology and modalities of clinical presentation, treatment options. He is author of a number of scientific publications on international journals, and presented results of his research at national and international scientific meetings. He is active member of: American Society of Colon and Rectal Surgeons (ASCRS); European Society of Coloproctology (EACP); Società Italiana di Chirurgia (SIC); Società Italiana di Chirurgia Oncologica (SICO); Società Italiana di Chirurgia Colorettale (SICCR) He is National Secretary of the Società Italiana di Chirurgia Colorettale (SICCR) He is National Scientific Secretary of the Italian Group for Sacral Neuromodulation (GINS).   GIOVANNI BATTISTA DOGLIETTO. He was born in Sparone (TO), April 17th, 1948. He was graduated in Medicine and Surgery at the Catholic University of Rome. Specialist in General Surgery and Urology. He is the Chief of the Division of Digestive Surgery of "A. Gemelli" Hospital, and Ordinary Professor of General Surgery at Catholic University, Rome. His clinical practice concerns particularly the colo-recto-anal diseases, as well as the other GI neoplasms and diseases. He is involved in the management of fecal incontinence. He is actively involved in research on GI diseases. He is author of more than 500 scientific publications on national and international journals. He is active member of: Società Italiana di Chirurgia (SIC); Società Italiana di Chirurgia Oncologica (SICO); Società Italiana di Chirurgia Colorettale (SICCR)

Foreword 5
Foreword 7
Foreword 9
Preface 11
Contents 13
List of Contributors 16
Structure and Function in Continence and Incontinence 21
Anatomy and Physiology of Continence 22
Invited Commentary 32
Epidemiology of Faecal Incontinence 36
Pathophysiology of Faecal Incontinence 53
Invited Commentary 58
Risk Factors in Faecal Incontinence 60
Psychological Aspects of Faecal Incontinence 84
Impact of Fecal Incontinence on Quality of Life 89
Social Aspects and Economics of Fecal Incontinence 94
Diagnosis of Fecal Incontinence 101
Clinical Assessment of the Incontinent Patient 102
Diagnosis of Fecal Incontinence 107
Imaging of Faecal Incontinence with Endoanal Ultrasound 118
Imaging of Fecal Incontinence 130
Invited Commentary 138
Invited Commentary 140
Diagnostic Workup in Incontinent Patients: An Integrated Approach 145
Invited Commentary 158
Treatment of Fecal Incontinence 161
Patient Selection and Treatment Evaluation 162
Medical Treatment of Fecal Incontinence 171
Rehabilitation and Biofeedback 174
Sphincteroplasty 178
Invited Commentary 183
Postanal Pelvic Floor Repair 185
Dynamic Graciloplasty 190
Invited Commentary 195
The Artificial Bowel Sphincter in the Treatment of Severe Fecal Incontinence in Adults 197
Invited Commentary 205
Gluteoplasty for the Treatment of Fecal Incontinence 208
Sacral Nerve Stimulation 214
Invited Commentary 221
Injectable Bulking Agents 224
Invited Commentary 230
Radiofrequency 231
Physiological Parameters Predicting the Outcome of Surgical and Nonsurgical Treatment of Fecal Incontinence 234
Selected Clinical Conditions 239
Rectal Resection 240
Iatrogenic Sphincter Lesions 249
Rectal Prolapse 258
Sphincter Atrophy 263
Obstetric Lesions: The Coloproctologist’s Point of View 268
Obstetric Lesions: The Gynaecologist’s Point of View 279
Neurogenic Fecal Incontinence 287
Diabetes 300
Fecal Incontinence in Elderly and Institutionalized Patients 310
Pelvic Radiotherapy 317
Double Incontinence 323
Invited Commentary 331
Pediatric Fecal Incontinence 333
Future Perspectives 343
Future Perspectives in Management and Research of Fecal Incontinence 344
Subject Index 349