LONG-TERM EVOLUTION OF CONTINENCE AND QUALITY OF LIFE AFTER SPHINCTEROPLASTY FOR OBSTETRIC FECAL INCONTINENCE

• Published in: Annals of coloproctology Vol. 38; no. 1; pp. 13 - 19
• Main Authors: Pla-Martí, Vicente, Martín-Arévalo, Jose, Martí-Fernández, Rosa, Moro-Valdezate, David, García-Botello, Stephanie, Espí-Macías, Alejandro, Mínguez-Pérez, Miguel, Ruiz-Carmona, Maria Dolores, Roig-Vila, Jose Vicente
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Coloproctology 28-02-2022; 대한대장항문학회
• Subjects: fecal incontinence; Original; quality of life; sphincter injury; sphincteroplasty; 일반외과학; quality of life; fecal incontinence; sphincteroplasty; obstetric anal sphincter injury
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2020.09.16

Evaluate the long-term evolution of continence and patient's quality of life after surgical treatment for obstetric fecal incontinence.
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 six years later. Degree of fecal incontinence was calculated using the Cleveland Clinic Score. Quality of life assessment was carried out with the Fecal Incontinence Quality of Life Scale.
35 patients with median age of 55 (range, 28-73) completed the study. Phase One Results: After a postoperative follow-up of 30 months (4-132), Cleveland Clinic Score had improved significantly from a preoperative of 15.7 ± 3.1 to 6.1 ± 5 (p <0.001). Phase Two Results: median follow-up in phase two was 110 months (76- 204). The Cleveland Clinic Score lowered to 8.4 ± 4.9 (p = 0.04). There were no significant differences between phases one and two 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 ± 0.9 vs 3.12 ± 1).
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.