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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2022; 10(20): 6845-6854
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6845
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6845
Efficacy of Kegel exercises in preventing incontinence after partial division of internal anal sphincter during anal fistula surgery
Pankaj Garg, Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula 134113, Haryana, India
Pankaj Garg, Department of Colorectal Surgery, Indus International Hospital, Mohali 140507, Punjab, India
Vipul D Yagnik, Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Center, Patan 384265, Gujarat, India
Baljit Kaur, Department of Radiology, SSRD Magnetic Resonance Imaging Institute, Chandigarh 160011, India
Geetha R Menon, Department of Statistics, Indian Council of Medical Research, New Delhi 110029, India
Sushil Dawka, Department of Surgery, SSR Medical College, Belle Rive 744101, Mauritius
Author contributions: Garg P conceived and designed the study, collected and analyzed the data, revised the data, finally approved and submitted the manuscript (Guarantor of the study); Yagnik VD and Kaur B collected the data; Yagnik VD, Kaur B and Menon GR analyzed the data, revised the data, finally approved and submitted the manuscript; Dawka S critically analyzed the data, reviewed and edited the manuscript, finally approved and submitted the manuscript.
Institutional review board statement: The study was reviewed and approved by the Indus International Hospital-Institute Ethics Committee (IIH-IEC), No. EC/IIH-IEH/SP6.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author, Dr. Pankaj Garg at drgargpankaj@gmail.com . Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pankaj Garg, MBBS, MS, Associate Professor, Department of Colorectal Surgery, Garg Fistula Research Institute, 1042/15, Panchkula 134113, Haryana, India. drgargpankaj@gmail.com
Received: January 14, 2022
Peer-review started: January 14, 2022
First decision: May 10, 2022
Revised: May 12, 2022
Accepted: June 13, 2022
Article in press: June 13, 2022
Published online: July 16, 2022
Peer-review started: January 14, 2022
First decision: May 10, 2022
Revised: May 12, 2022
Accepted: June 13, 2022
Article in press: June 13, 2022
Published online: July 16, 2022
Core Tip
Core Tip: This is the first study in which the incidence of fecal incontinence, especially urge incontinence, has been studied after an anal fistula procedure that involves division of only the internal anal sphincter and sparing of the external anal sphincter. Overall incontinence occurred in 31% of patients in the postoperative period. Urge and gas incontinence accounted for the majority of incontinence cases (28.3%). The benefits of Kegel exercises (KE) in reversing fecal incontinence have been highlighted for the first time. KE initiated early in the postoperative period reversed incontinence in a significant majority of patients. Even in patients with residual incontinence, the severity of incontinence became significantly reduced.