Original Article

Use of anal sling in the treatment of faecal incontinence

  • FILIPPO LA TORRE
  • FRANCESCO VELLUTI
  • ANNA FARINA
  • GIUSEPPE GIULIANI
  • DIEGO COLETTA
  • FABIANO IAQUINANDI
  • ERRICO ORSI
  • LIVIA DE ANNA
  • FRANCA NATALE
  • MAURO CERVIGNI

Pelviperineology 2013;32(1):9-13

Fecal incontinence is defined as the recurrent uncontrolled passage of faecal material for at least 1-month duration. It affects people of all age and especially middle-aged women, nursing home residents and elderly. The evaluation includes a detailed clinical assessment with an appropriate physiological exam and imaging tests of the anorectum to provide information regarding the etiology and the severity of the problem. Before considering surgery, medical treatment, such as diet correction, fibers, transit delay, little enemas and rehabilitation must have failed. Selecting patients is critical in surgical treatment. In carefully selected patients with severe incontinence and rectal prolapse, who have not had acceptable improvement in symptoms the transobturator anal sling can be considered an alternative among the options. Implants for surgical treatment is a therapeutic option derived from experience by urogynecologists. Bioreabsorbing materials placed (tension free) along puborectalis muscle’s line support pelvic diaphragm creating an elastic structure. The specific type of net for these applications is made by the monofilament of Prolene®, manufactured by Ethicon Inc.®, and diffused under the trade name of Net Polypropylene PROLENE®. In our personal experience 12 patients underwent surgery between 2006 and 2009. Intervention is feasible in early and advanced phase of fecal incontinence and rectal or pelvic prolapse.Even if this procedure is invasive, can be considered relatively simple and effective. None of patients had complications in subsequent follow-up.

Keywords: Anal sling; Fecal incontinence; Surgical treatment; Prosthetic mesh.