Bougie A, McFadden N, Mayer S, Lebel M, Devroede G. Neurostimulation for fecal incontinence after correction of repair of imperforate anus. World J Clin Cases 2017; 5(3): 124-127 [PMID: 28352637 DOI: 10.12998/wjcc.v5.i3.124]
Corresponding Author of This Article
Dr. Ghislain Devroede, MD, MSc, Professor of Surgery, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, 580, rue Bowen Sud, Sherbrooke, QC J1H 5N4, Canada. g.devroede@sympatico.ca
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2017; 5(3): 124-127 Published online Mar 16, 2017. doi: 10.12998/wjcc.v5.i3.124
Neurostimulation for fecal incontinence after correction of repair of imperforate anus
Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Michel Lebel, Ghislain Devroede
Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Ghislain Devroede, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
Michel Lebel, Medicine Department, Neurology, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
Author contributions: Bougie A contributed to the conception and design of the report; all authors contributed to the collection of the patient’s clinical data as well as the writing, revision and approval of the article.
Institutional review board statement: The study was reviewed and approved by the Centre Hospitalier Universitaire de Sherbrooke (CHUS) Institutional Review Board.
Informed consent statement: The patient gave informed, written consent for publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Ghislain Devroede, MD, MSc, Professor of Surgery, Surgery Department, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, 580, rue Bowen Sud, Sherbrooke, QC J1H 5N4, Canada. g.devroede@sympatico.ca
Received: June 27, 2016 Peer-review started: June 29, 2016 First decision: August 5, 2016 Revised: November 2, 2016 Accepted: November 21, 2016 Article in press: November 23, 2016 Published online: March 16, 2017 Processing time: 258 Days and 14.2 Hours
Abstract
We are reporting the case of a 32-year-old female who had suffered from fecal incontinence (FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.
Core tip: Fecal incontinence is frequent among young adults who have suffered from an imperforate anus. This condition needs to be better understood by adult surgeons, and evaluation of the repair is necessary. This case report describes exams done to confirm the abnormal position of the anus in relation to the sphincter complex and what was done to improve the condition of the patient. Surgery and neurostimulation were complementary and dramatically improved the quality of life of this patient.
