Editorial
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World J Gastroenterol. Nov 14, 2010; 16(42): 5267-5271
Published online Nov 14, 2010. doi: 10.3748/wjg.v16.i42.5267
Sphincteroplasty for fecal incontinence in the era of sacral nerve modulation
Donato F Altomare, Michele De Fazio, Ramona Tiziana Giuliani, Giorgio Catalano, Filippa Cuccia
Donato F Altomare, Michele De Fazio, Ramona Tiziana Giuliani, Giorgio Catalano, Filippa Cuccia, General Surgery and Liver Transplantation Units, Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 11-70124 Bari, Italy
Author contributions: Altomare DF designed and wrote the paper, and approved the final version; De Fazio M, Giuliani RT and Catalano G reviewed and analyzed the literature, wrote the paper and approved the final version; Cuccia F wrote the paper and approved the final version.
Correspondence to: Donato F Altomare, MD, Associate Professor, General Surgery and Liver Transplantation Units, Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, Policlinico, Piazza G Cesare, 11-70124 Bari, Italy. altomare@clichiru.uniba.it
Telephone: +39-80-5592107 Fax: +39-80-5478735
Received: April 12, 2010
Revised: May 24, 2010
Accepted: June 1, 2010
Published online: November 14, 2010
Abstract

The role of sphincteroplasty in the treatment of patients with fecal incontinence due to anal sphincter defects has been questioned because the success rate declines in the long-term. A new emerging treatment for fecal incontinence, sacral nerve stimulation, has been shown to be effective in these patients. However, the success rate of sphincteroplasty may depend of several patient-related and surgical-related factors and the outcome from sphincteroplasty has been evaluated differently (with qualitative data) from that after sacral nerve stimulation (quantitative data using scoring systems and quality of life). Furthermore, the data available so far on the long-term success rate after sacral nerve modulation do not differ substantially from those after sphincteroplasty. The actual data do not support the replacement of sphincteroplasty with sacral nerve stimulation in patients with fecal incontinence secondary to sphincter defects.

Keywords: Fecal incontinence; Sacral nerve stimulation; Sphincteroplasty