Ann Coloproctol.
2022 Feb;38(1):13-19. 10.3393/ac.2020.09.16.
Long-term evolution of continence and quality of life after sphincteroplasty for obstetric fecal incontinence
- Pla-Martí V
1,2 - Martín-Arévalo J2
- Martí-Fernández R2
- Moro-Valdezate D1,2
- García-Botello S1,2
- Espí-Macías A1,2
- Mínguez-Pérez M3
- Ruiz-Carmona MD4
- Roig-Vila JV5
- Affiliations
-
- 1Department of Surgery, University of Valencia, Valencia, Spain
- 2Colorectal Unit, Department of General and Digestive Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain
- 3Digestive Motility Unit, Department of Digestive Medicine, Hospital Clínico Universitario de Valencia, Valencia, Spain
- 4Department of Surgery, Hospital of Sagunto, Valencia, Spain
- 5Colorectal Unit, Hospital Nisa 9 de Octubre, Valencia, Spain
- KMID: 2526562
- DOI: http://doi.org/10.3393/ac.2020.09.16
Abstract
- Purpose
This study was performed to evaluate the long-term evolution of continence and patient’s quality of life after surgical treatment for obstetric fecal incontinence.
Methods
A prospective longitudinal study was conducted including consecutive patients who underwent sphincteroplasty for severe obstetric fecal incontinence. The first phase analyzed changes in continence and impact on quality of life. The second phase studied the long-term evolution reevaluating the same group of patients 6 years later. Degree of fecal incontinence was calculated using the Cleveland Clinic Score (CCS). Quality of life assessment was carried out with the Fecal Incontinence Quality of Life scale.
Results
Thirty-five patients with median age of 55 years (range, 28 to 73 years) completed the study. Phase 1 results: after a postoperative follow-up of 30 months (4 to 132 months), CCS had improved significantly from a preoperative of 15.7 ± 3.1 to 6.1 ± 5.0 (P < 0.001). Phase 2 results: median follow-up in phase 2 was 110 months (76 to 204 months). The CCS lowered to 8.4 ± 4.9 (P = 0.04). There were no significant differences between phases 1 and 2 in terms of quality of life; lifestyle (3.47 ± 0.75 vs. 3.16 ±1.04), coping/behavior (3.13 ±0.83 vs. 2.80 ±1.09), depression/self-perception (3.65 ±0.80 vs. 3.32 ± 0.98), and embarrassment (3.32 ± 0.90 vs. 3.12 ± 1.00).
Conclusion
Sphincteroplasty offers good short-medium term outcomes in continence and quality of life for obstetric fecal incontinence treatment. Functional clinical results deteriorate over time but did not impact on patients’ quality of life.
