Effectiveness of Autologous Fat Graft in Treating Fecal Incontinence

Jeong, Hyeonseok; Hwang, Sung Hwan; Kim, Hyoung Rae; Ryu, Kil O; Lim, Jiyong; Yu, Hye Mi; Yoon, Jihoon; Kim, Chee Young; Jeong, Kwang Yong; Jung, Young Jae; Jeong, In Seob; Choi, Young Gil

Abstract

PURPOSE
The most common risk factor for fecal incontinence (FI) is obstetric injury. FI affects 1.4%-18% of adults. Most patients are unaware when they are young, when symptoms appear suddenly and worsen with aging. Autologous fat graft is widely used in cosmetic surgical field and may substitute for injectable bulky agents in treating FI. Authors have done fat graft for past several years. This article reports the effectiveness of the fat graft in treating FI and discusses satisfaction with the procedure.
METHODS
Fat was harvested from both lateral thighs using 10-mL Luer-loc syringe. Pure fat was extracted from harvests and mixed with fat, oil, and tumescent through refinement. Fats were injected into upper border of posterior ano-rectal ring, submucosa of anal canal and intersphincteric space. Thirty-five patients with FI were treated with this method from July 2016 to February 2017 in Busan Hangun Hospital. They were 13 male (mean age, 60.8 years) and 22 female patients (mean age, 63.3 years). The Wexner score was checked before procedure. We evaluated outcome in outpatients by asking the patients. For 19 patients we checked the Wexner score after procedure.
RESULTS
Symptom improved in 29 (82.9%), and not improved in 6 (17.1%). In 2 of 6 patients, they felt better than before procedure, although not satisfied. No improvement in 4. Mean Wexner score was 9.7 before procedure. There were no serious complications such as inflammation or fat embolism.
CONCLUSION
Autologous fat graft can be an effective alternative treatment for FI. It is safe and easy to perform, and cost effective.