Title : Innovative approaches in restoring fecal continence: The modified preanal-repair concept for post-childbirth trauma
Abstract:
Fecal incontinence (FI) is a distressing condition that severely impacts the quality of life, leading to profound psychological, social, and physical challenges. Affecting approximately 2% of the general population, its prevalence is notably higher in elderly individuals and those in long-term care facilities. Among the most significant causes of FI are sphincter injuries resulting from childbirth, which, if not adequately addressed, can lead to chronic incontinence and a substantial decrease in the quality of life.
The modified Preanal-Repair concept, a surgical innovation developed and refined in our clinic since 2000, offers a novel and effective solution for patients suffering from FI, particularly those with sphincter injuries, whether recent or old. This technique encompasses a series of reconstructive steps that aim to restore the integrity and function of the anal sphincter and pelvic floor. Crucially, it avoids the resection of scar tissue, thereby minimizing the risk of further damage and preserving sphincter function.
The procedure involves overlapping sphincter muscles using a non-resorbable suture technique, which enhances the repair's stability and durability. By addressing concomitant issues such as rectocele and perineal descent, the modified Preanal-Repair concept not only improves continence but also enhances the overall pelvic floor function. Clinical outcomes have demonstrated significant improvements in continence and patient quality of life, even in cases with longstanding injuries. Ongoing follow-up studies are expected to further validate these positive outcomes.
Audience Take Away Notes:
- Comprehensive insights into the epidemiology, etiology, and psychosocial impacts of fecal incontinence, with a focus on childbirth-related trauma
- Detailed procedural knowledge of the modified Preanal-Repair technique, including its indications, surgical steps, and postoperative care
- The significance of early and effective intervention in managing sphincter injuries to prevent chronic fecal incontinence and improve long-term outcomes
- Healthcare professionals, particularly those in surgical and gynecological specialties, will acquire practical knowledge that can be directly applied in clinical settings. The presentation will equip them with the necessary skills to implement the modified Preanal-Repair technique, thereby enhancing their ability to manage complex cases of fecal incontinence. Furthermore, the insights gained will enable them to better counsel patients regarding treatment options and expected outcomes
- The refined surgical approach presented will expand the therapeutic arsenal available to surgeons and gynecologists, enabling them to offer more effective and tailored treatments for patients suffering from fecal incontinence. By improving surgical outcomes and reducing the likelihood of recurrence, this technique will contribute to better patient satisfaction and a higher standard of care in their practice
- This presentation provides a foundation for further research into the long-term efficacy and safety of the modified Preanal-Repair technique. It also serves as a valuable educational resource for faculty teaching advanced colorectal surgery and pelvic floor disorders, offering a detailed case study that can enhance both research and teaching efforts
- The modified Preanal-Repair concept offers a practical and streamlined solution for the surgical repair of sphincter injuries. By avoiding the resection of scar tissue and employing a stable, overlapping suture technique, the procedure simplifies the repair process while ensuring more reliable outcomes, making it an efficient choice for surgeons
- The surgical technique presented introduces new insights into the management of sphincter injuries, providing a more accurate and reliable method for restoring continence. This innovative approach could influence the design of future surgical protocols and training programs, ensuring that they incorporate the most effective and up-to-date practices in fecal incontinence management
