Anal incontinence

Anal incontinence is a very frequent problem especially among elderly woman, which have given birth. Anal incontinence is diagnosed and treated by ZweiChirurgen at our centre for proctology in Switzerland in Basel, Zurich and Liestal.

The patients suffer from inadvertent loss of stool, gas, and mucus. The quality of life is reduced in most cases, since patients are fearing to go outside and meet friends because of a “potential accident”. The grad of the anal incontinence is measured using the “Vaizey-Wexner” score. Also, the disease is divided into a primary incontinence (damage to the nerves which regulate the sphincter muscle function) and secondary forms of incontinence (e. g. insufficiency of the sphincter muscle, pelvic floor disorders or chronic constipation).

Beside detailed history taking and assessment of the grade of anal incontinence a careful rectal examination will confirm the diagnosis. Sometimes, imaging modalities such as MRI scans or endoanal ultrasound as well as functional tests (endoanal manometry) are necessary.

The treatment is highly depending on the cause for the incontinence and the psychological strain. In many cases pelvic floor physiotherapy or stool regulation are sufficient. Rarely an operation is indicated.

• Conservative treatment
  – Pelvic floor physiotherapy
  – Biofeedback training
  – Stool regulation
• Surgical sphincter reconstruction
• Minimally-invasive silicone implants
• Radiofrequency ablation (RFA, Secca-operation)