Functional Outcome and Life Quality after Unilateral Fixed Proximally- Based Gluteoplasty for End-Stage Fecal Incontinence

• Main Authors: Mahmoud Abdelnaby (Author), Mohamed El-Said (Author), Sameh Hany Emile (Author), Ahmed Abdel Mawla (Author)
• Format: Book
• Published: Journal of Surgery and Surgical Research - Peertechz Publications, 2017-02-28.
• Subjects: Research Article
• Online Access: Connect to this object online.

<p><strong>Introduction:</strong> Many patients with fecal incontinence (FI) have no treatment option except diversion. Gluteoplasty can be the ultimate resort for these patients despite unsatisfactory long term functional results. Different gluteoplasty techniques were described. The aim of this study was to evaluate the impact of fixing the proximally-based gluteus muscle flap to the contralateral ischial tuberosity on functional outcome in patients with end-stage FI.</p><p><strong>Patients and methods:</strong> Prospectively collected data of 17 patients with end-stage FI managed with unilateral proximally-based fixed gluteoplasty were retrospectively reviewed. Endoanal ultrasound and electromyography were performed before surgery to assess the condition of anal sphincter and gluteus maximus muscles. Patients were evaluated preoperatively and six months postoperatively by Wexner continence score and fecal incontinence quality of life questionnaire.</p><p><strong>Results:</strong> All patients showed significant improvement in the continence state and quality of life after surgery. Patients with an adequate external anal sphincter (EAS) remnant (> 50%) were completely continent or complained only of minor FI while those with larger EAS defects were continent only to solid stool, however showed significant improvement in life quality.</p><p><strong>Conclusion:</strong> Proximally-based fixed gluteoplasty can improve life quality and restore complete continence in patients with an adequate EAS remnant and partial continence in patients with larger EAS defects.</p>