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Forewordby Ann C. Lowry Several years ago, the American media presented urinary incontinence as the "last closet issue". Arguably, that designation really belongs to fecal incontinence. Even today, only a third of patients suffering with the condition discuss it with their physicians. This is particularly unfortunate, as the condition affects a significant portion of the population and is a significant burden to patients, their families, and society. This situation exists for a number of reasons...
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Ratto l Doglietto Editors Fecal Incontinence Diagnosis and Treatment Fecal incontinence is a frequent, distressing condition that has a devastating impact on patients' lives. However, patients are typically embarrassed and reluctant to acknowledge this disability, so they relinquish the possibility of being cured and remain socially isolated. Since fecal incontinence may result from various pathophysiological situations, an accurate diagnostic work-up of each patient is fundamental. ... [weiter lesen] |
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Contents
List of ContributorsXVII
Section I
STRUCTURE AND FUNCTION IN CONTINENCE AND INCONTINENCE
1 Anatomy and Physiology of Continence
A.E. BHARUCHA, R.E. BLANDON 3
Invited Commentary P.J. LUNNISS, S.M. SCOTT 13
2 Epidemiology of Faecal Incontinence
A.K. MACMILLAN, A.E.H. MERRIE 17
3 Pathophysiology of Faecal Incontinence
L. ZORCOLO, D.C.C. BARTOLO 35
Invited Commentary A.-M. LEROI 40
4 Risk Factors in Faecal Incontinence
S.M. SCOTT, P.J. LUNNISS 43
5 Psychological Aspects of Fecal Incontinence
J.M. STERN 67
6 Impact of Fecal Incontinence on Quality of Life
T.H. ROCKWOOD 73
7 Social Aspects and Economics of Fecal Incontinence
C. RATTO, P. PONZI, F. DI STASI, A. PARELLO 79
Section II
DIAGNOSIS OF FECAL INCONTINENCE
8 Clinical Assessment of Incontinent Patient
H. ORTIZ, M. DE MIGUEL, M.A. CIGA 89
9 Diagnosis of Fecal Incontinence
S.S.RAO,J.SIDDIQUI 95
10 Imaging of Faecal Incontinence with Endoanal Ultraosund
R.J. F .FELT-BERSMA 107
11 Imaging of Fecal Incontinence
A.MAIER 119
Invited Commentary T.L.HULL 127
Invited Commentary G.A.SANTORO 129
12 Diagnostic Work-up in Incontinent Patients: An Integrate Approach
C.RATTO,A.PARELLO,L.DONISI, F. LITTA,G.B.DOGLIETTO 135
Invited Commentary S.R.STEELE,A.C.LOWRY,A.F.MELLGREN 148
Section III
TREATMENT OF FECAL INCONTINENCE
13 Patient Selection and Treatment Evaluation
C.RATTO,A.PARELLO,L.DONISI,F.LITTA,G.B.DOGLIETTO 153
14 Medical Treatment of Fecal Incontinence
C.RATTO,A.PARELLO,L.DONISI, F. LITTA,G.B.DOGLIETTO 163
15 Rehabilitation and Biofeedback
F. PUCCIANI 167
16 Sphincteroplasty
J.W.OGILVIE JR.,R.D.MADOFF 171
Invited Commentary D.F.ALTOMARE 176
17 Postanal Pelvic Floor Repair
S.M.ABBAS,LP.BISSETT 179
18 Dynamic Graciloplasty
C.G.M.I.BAETEN,J.MELENHORST 185
Invited Commentary H.R.ROSEN 190
19 The Artificial Bowel Sphincter in the Treatment of Severe Fecal Incontin...
P.-A.LEHUR,G.MEURETTE 193
Invited Commentary F.LA TORRE 201
20 Gluteoplasty for the Treatment of Fecal Incontinence
L.E.MCPHAIL,C.S.HULTMAN 205
21 Sacral Nerve Stimulation
K.E.MATZEL 211
Invited Commentary F.H.HETZER 218
22 Injectable Bulking Agents
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Subject Index
Aanal canal 3-7, 9, 11, 14, 16, 35, 37, 40, 44, 46, 55-58, 91, 95-97, 100, 101, 103, ...
anal canal anatomy 120, 127
Anatomy 3, 9, 13-15, 95, 107, 108, 110, 114, 120-122, 127-130, 148, 179, 180, 205, 20...
anal canal length 55, 91, 155, 174, 233
anal dilatation 37, 55, 56, 111, 241, 251, 252, 253, 255
anal sphincter 3-10, 13, 14, 35-37, 40, 43, 44, 46, 48, 51-58, 95-102, 107-114, 119-1...
anal surgery 36, 45, 54, 89, 90, 131
anococcygeal ligament 108, 109, 130, 138
anorectal angle 8, 37, 44, 91, 96, 100, 110, 142, 155, 168, 179, 182, 206, 262, 278
anorectal electrophysiology 136, 139, 144, 149, 154, 355
anorectal function 35, 40, 41, 97, 101, 102, 107, 114, 168, 195, 242, 267, 301, 301, ...
anorectal manometry 91, 99-102, 136, 137, 144, 149, 154, 164, 169, 195, 242, 243, 245...
anxiety 68, 69, 74, 80, 143, 310, 317, 354
artificial bowel sphincter 40, 156, 157, 186, 190, 193-197, 199, 201, 211, 213, 264, ...
autonomic dysfunction 298, 299, 308, 309, 310
autonomic nervous system 48, 294
Bballoon expulsion test 101
behavioral therapy 120, 355
bimanual examination of the rectovaginal septum 91
biofeedback 70, 71, 74, 96, 101, 102, 104, 105, 118, 119, 120, 144, 147, 154, 155, 16...
bladder 3, 5, 8, 27, 49, 50, 67, 95, 145, 186, 195, 213, 218, 219, 221, 242, 294-301,...
brain 13, 40, 43, 44, 49, 97, 98, 164, 222, 293, 294, 313
bulking agents 143, 148, 155, 158, 163, 164, 173, 205, 221, 224, 227, 243, 264, 280, ...
Ccentral nervous system (CNS) 9, 43, 47, 97, 98, 144, 145, 158, 164, 215, 236, 294, 2...
cerebrovascular disease 294, 295
cesarean section 107, 276, 334
chemoradiation 215, 241, 242, 325, 328
childbirth 20, 36, 50, 51, 54, 74, 114, 119, 121, 127, 128, 155, 205, 267, 273, 274, ...
clinical assessment 89, 91, 98, 135, 143, 153, 154, 300, 311
coccygeus 3, 95, 130-132, 181
Colonoscopy 82, 100, 243, 261, 312
coloproctologists 356
colostomy 171, 172, 174, 185, 187, 190, 193, 194, 198, 199, 202, 207, 209, 314, 342, ...
congenital 45, 46, 84, 144, 341
conservative treatments 201, 335
constipation 13, 14, 18, 36, 40, 46-48, 57, 64, 65, 96, 120, 157, 163, 164, 173, 186,...
continence 3, 8, 13-15, 35, 37, 43, 44, 46-48, 50, 51, 53, 55, 56-58, 67, 68, 89, 92,...
coping behaviors 75
coping mechanisms 43, 69, 76, 354
Crohn's disease 29, 49, 97, 98, 163, 199, 208, 253
DDefecography 119, 123, 124, 129, 142, -145, 148, 149, 154, 164, 172, 186, 277, 312, ...
degeneration 36, 45, 98, 112, 121-124, 143, 157, 213, 236, 242, 245, 269, 299, 310
dementia 36, 46, 47, 57, 97, 98, 294, 295, 317, 318, 320, 321, 334
depression 3, 57, 68, 69, 74, 75, 83, 167, 197, 212, 214, 288, 310, 314, 317, 354
diabetes 29, 36, 43, 45, 47, 48, 97, 98, 100, 101, 119, 138, 144, 145, 163, 182, 199,...
diagnosis 17, 67, 80, 82, 83, 89, 95, 98, 99, 102, 103, 107, 117, 119, 120, 123, 124,...
diarrhea 9, 40, 89, 91, 97, 98, 100, 102, 107, 111, 114, 136, 154, 157, 158, 163, 164...
digital examination 89, 91, 107, 143, 158, 243, 312, 320
double incontinence 68, 219, 317, 331, 332, 338, 339
dynamic graciloplasty 143, 153, 155-157, 169, 176, 185-188, 190, 211, 213, 218, 235, ...
dyssynergia 15, 57, 101, 142
Eeconomics 79, 81
elderly 17, 20, 36, 43, 48, 57, 67, 91, 101, 109, 144, 145, 218, 224, 255, 261, 263, ...
Electromyography 119, 140, 144, 149, 176, 180, 182, 273, 296, 311, 312
Electrophysiology 136, 139, 144, 145, 149, 154, 164, 243, 245, 355
Embryology 3, 350
encopresis 18, 21, 57, 67, 341
endoanal ultrasound 51, 54, 58, 97, 107, 109, 119, 120, 131, 136, 138-140, 144, 148, ...
Endoscopy 91, 100, 103, 136
Endosonography 101, 107, 108, 109, 110, 113, 118, 120-124, 127, 128, 133, 258, 267, 3...
enterocele 91, 123, 124, 142, 157, 186
Epidemiology 17, 74, 307, 339
Etiology 18, 36, 43, 49, 50, 67, 69, 89, 97, 98, 100, 119, 157, 167, 208, 233, 241, 2...
European Quality of Life (Euro-Qol) 73
experience with fecal incontinence 76
external sphincter 3, 5-7, 9, 10, 14, 37, 46-48, 96, 119-124, 131, 149, 168, 180-182,...
Ffamily members 70
fecal continence 3, 8, 89, 102, 161, 167, 185, 195, 196, 198, 208, 211, 245, 267, 293...
fecal incontinence 9, 10, 73-76, 79, 81-84, 89, 90, 92, 95-102, 119-124, 127-129, 131...
Fecal Incontinence Quality of Life (FIQL) 197, 212, 214, 229, 288
fistula surgery 29, 55, 56, 111, 131, 251, 253
fistulotomy 43, 56, 90, 97, 98, 107, 114, 121, 171, 251, 253
GGastrointestinal Quality of Life Index (GIQLI) 74
gynaecologists 274, 285, 289
Gluteoplasty 155-157, 205-209
Gluteus muscle 185, 205-208
Gracilis muscle 156, 185-188, 191, 205, 206, 235, 243
graciloplasty 143, 153, 155-157, 169, 176, 185-188, 190, 191, 195, 198, 201, 206, 209...
group therapy 69, 71
HHealth-Related Quality of Life (HRQoL) 73, 75, 76, 327
Hemorrhoidectomy 97, 98, 107, 111, 128, 131, 171, 321
hyposensitivity 13, 36, 57, 58, 100, 215
Iiatrogenic 45, 50, 55, 56, 98, 111, 144, 145, 157, 176, 205, 234, 241, 245, 251, 252...
iliococcygeus 4, 130, 132
Imaging 8, 13, 40, 89, 91, 96-98, 107-110, 119-124, 127-132, 136, 138, 143-145, 148, ...
implantable stimulator 186
incidence 9, 10, 17, 18, 21, 51-57, 112, 196, 209, 235, 242, 252, 261, 273-276, 285, ...
inflammatory bowel disease 29, 49, 89, 91, 136, 158, 172, 207, 229, 312
injectable bulking agents 155, 158, 221, 225, 227, 264
inspection 89, 99, 123, 136, 148, 172, 277, 312
- perineum inspection 89
- Valsalva maneuver 8, 90, 91, 342
instruments 10, 28, 73-76, 80, 81, 140, 153, 214, 222
internal sphincter 5, 7, 14, 46, 48, 49, 96, 97, 111, 119-123, 156-158, 180, 227, 230...
interpretation of studies 19, 36, 143, 274, 325, 328
intussusception 14, 57, 58, 91, 119, 123, 124, 136, 142, 157, 186, 255, 261, 312, 332
irritable bowel syndrome 29, 35, 45, 49, 61, 68, 74, 97, 138, 154, 208, 308, 313, 321...
Llateral sphincterotomy 54, 107, 251, 252
leads 47, 58, 101, 111, 119, 120, 214, 215, 218, 222, 296, 297, 314, 333, 342, 348
leakage 14, 18, 20, 26, 27, 30, 31, 43, 56, 57, 68, 91, 92, 99, 102, 119, 120, 124, 1...
levator ani 3, 4, 6, 13, 14, 44, 95, 96, 107, 108, 119, 131, 168, 179-181, 211, 278, ...
MMagnetic resonance defecography 142
Magnetic resonance imaging (MRI) 13, 96, 97, 107, 127, 129, 144, 172, 179, 267, 268, ...
Manchester Health Questionnaire 74, 75
manometry 8, 36, 82, 91, 96, 99, 100, 101, 113, 120, 122, 136, 144, 149, 154, 164, 16...
maximum tolerated volume 137, 242, 243
medical treatment 40, 79, 154, 163, 193, 347, 348
megarectum 13, 14, 45, 47, 57, 91, 317, 318, 320, 321, 342
multimodal rehabilitation 167, 169
multiple sclerosis 43, 45, 47, 68, 97, 98, 101, 218, 294, 296, 332, 353
myelopathies 296
myenteric plexus 5, 96, 97, 242, 294-297
Myopathy 45, 46, 98, 304
Nneurogenic 36, 96, 119, 122, 141, 142, 145, 157, 158, 191, 198, 199, 211, 234, 245, ...
neuropathic incontinence 180, 182
neurophysiologic investigations 299, 300
OObesity 46
obstetric 10, 43, 46, 50-54, 56, 90, 91, 97, 101, 107, 108, 110-112, 119, 121, 123, 1...
obstetric fistula 273
obstetric injury 10, 43, 56, 101, 112, 121, 251, 257, 273, 279, 333, 339, 354
obstetric lesions 144, 273, 285
occult sphincter injury 274, 280
outlet obstruction 15, 57, 123, 124, 216, 219
overflow incontinence 36, 46, 48, 57, 91, 164, 312, 318, 320
overlapping repair 10, 275, 278, 279, 287, 288
Ppalpation 89, 90, 120, 136, 227, 277, 332
- anocutaneous reflex 99, 211
parasympathetic nerves 7, 9, 44, 241, 242
Parkinson's disease 43, 47, 74, 294, 295, 332, 353
Pathophysiology 13, 14, 35, 40, 45, 47, 50, 53, 55, 57, 89, 98, 102, 136, 137, 143, 1...
patient selection 131, 153, 155, 157-159, 199, 200, 209, 211, 213, 216, 218, 354
pediatric 145, 341, 342, 354, 355
pelvic floor 3-6, 8, 11, 13-15, 35, 36, 44, 53, 54, 57, 74, 90, 91, 95-97, 100, 107-1...
pelvic radiation 325
pelvic radiotherapy 45, 50, 98, 144, 242, 325, 328
pelvic radiotherapy for rectal cancer 328
- Side-effects 9, 80, 164, 186, 313, 321, 325, 328
pelvic surgery 45, 135, 257
perineal
- body 18, 91, 108, 121, 130, 136, 138, 172, 173, 205, 243, 277, 333
- descent 8, 49, 58, 90, 99, 120, 133, 142, 144, 155, 156, 179, 198, 199, 243, 277, 3...
- laceration 10, 53, 205, 274, 285-291, 332, 333
perineum 54, 89, 90, 91, 97, 100, 109, 130, 136, 168, 185, 187, 199, 208, 214, 273, 2...
peripheral nerve evaluation (PNE) 199, 214, 236, 244, 245, 329
peripheral neuropathies 145, 298, 356
physical activity 27, 205
physical examination 89, 103, 135, 136, 148, 149, 153, 164, 277, 311, 318, 320, 323, ...
physiological test 50, 98, 102, 103, 154, 233, 245, 300, 319
postanal repair 93, 119, 155, 156, 179-181, 234, 235, 264, 267, 278, 314, 322
prevalence 17-21, 43, 48, 49, 50, 51, 60, 61, 119, 182, 193, 253, 273-276, 285, 287, ...
Proctography 37, 57, 123, 179, 180, 182, 262, 335
psychological factors 67, 70, 80
psychological treatment 69
psychosexual functioning 68, 69
pubococcygeus 3, 4, 95, 130, 131, 181
puborectalis 3-9, 13, 36, 37, 44, 91, 95-98, 100, 107-112, 114, 120, 130, 132, 136, 1...
pudendal nerve terminal motor latency (PNTML) 101, 102, 111, 119, 120, 141-145, 149, ...
Qquality of life (QOL) 18, 21, 43, 48, 67, 68, 73-75, 80, 81, 84, 92, 119, 135, 136, ...
questionnaires 17-19, 21, 93, 159, 195, 213, 221, 229, 242, 323
Rradiofrequency energy 221, 229, 230
Radiotherapy 45, 50, 98, 144, 145, 198, 218, 242, 243, 246, 256, 325, 326, 327, 328
rectal cancer 241-245, 256, 257, 259, 312, 325, 327, 328, 356
receptors 6, 14, 100, 294, 321
rectal evacuatory disorder 43, 45, 47, 57
rectal motility 36, 176, 215, 293, 308, 309
rectal prolapse 29, 45, 58, 90, 97-99, 114, 119, 123, 124, 136, 142, 144, 145, 148, 1...
rectal resection 9, 50, 144, 145, 215, 241, 243-246
rectal sensations 136, 137, 144, 156
rectocele 14, 49, 57, 90, 91, 119, 123, 136, 142-145, 186, 208, 251, 255, 332
Rectopexy 58, 261, 262, 267
rectovaginal fistula 90, 277, 279, 283
rehabilitation 80, 83, 153-155, 167, 168, 296
relaxation 5, 7-9, 35, 36, 40-49, 58, 96, 97, 101, 137, 138, 144, 168, 191, 215, 255,...
research 13-15, 21, 68, 73-76, 91, 112, 114, 127-129, 131, 149, 195, 203, 215, 216, 2...
reservoir incontinence 48, 319, 321
resting
- pressure 7, 9, 36, 46, 48, 56, 96, 137, 155, 156, 169, 172, 197, 215, 223, 236, 242...
- tone 7, 9, 14, 36, 37, 44, 53, 56, 96, 136, 168, 205, 245, 299, 318
risk factors 15, 17, 43, 45-48, 50, 51, 54, 56, 58, 97, 105, 182, 242, 275, 276, 295,...
risk of fecal incontinence 98, 297, 325, 327, 328
Ssacral nerve stimulation (SNS) 13, 40, 120, 143, 148, 155, 157, 190, 198, 199, 211, ...
sacral reflexes 8, 300
saline infusion test 102
sensory retraining 144, 154, 167, 168
severity 21, 43, 53, 68, 70, 75, 76, 89, 91, 92, 93, 97, 98, 110, 132, 136, 149, 153,...
severity scores 91, 93, 149
- grading scales 91, 92, 93
summary scales 91, 92, 93
Sexuality 68
shame 67, 68, 69, 71, 74-76, 84
Short Form-36 229
social aspects 79
soiling 18-21, 36, 43, 45-47, 50, 51, 55-57, 89, 92, 94, 98, 111, 120, 135, 136, 154,...
sphincter
- atrophy 107, 110, 113, 122, 123, 143-145, 267, 269, 322
- defect 9, 10, 40, 53-57, 91, 96, 97, 101, 107, 110-114, 119-123, 127, 131, 143, 144...
- reconstruction 120, 209, 354
- repair 101, 102, 107, 110, 111, 113, 114, 119, 124, 128, 171-173, 180, 190, 211, 21...
- tears 53, 54, 124, 135, 139, 143, 157, 273, 275, 333, 353, 355, 356
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