Fecal Incontinence: Diagnosis and Treatment

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Carlo Ratto, Giovanni B. Doglietto
Springer Science & Business Media, Oct 10, 2007 - Medical - 362 pages
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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. Today, a wide range of therapeutic options is available, but making the correct choice is pivotal to the successful management of this condition. This book is aimed at all physicians involved in the assessment and treatment of fecal incontinence. Its main purpose is to review the latest advances in the epidemiologic, socio-economic, psychologic, diagnostic, and therapeutic aspects of fecal incontinence, in order to establish guidelines for effective treatment.

 

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Contents

Anatomy and Physiology of Continence
3
Invited Commentary
13
Epidemiology of Faecal Incontinence
17
Pathophysiology of Faecal Incontinence
35
Invited Commentary
40
Risk Factors in Faecal Incontinence
42
Psychological Aspects of Faecal Incontinence
67
Impact of Fecal Incontinence on Quality of Life
73
The Artificial Bowel Sphincter in the Treatment of Severe Fecal Incontinence in Adults
193
Invited Commentary
201
Gluteoplasty for the Treatment of Fecal Incontinence
204
Sacral Nerve Stimulation
211
Invited Commentary
218
Injectable Bulking Agents
221
Invited Commentary
227
Radiofrequency
229

Social Aspects and Economics of Fecal Incontinence
78
Diagnosis of Fecal Incontinence
86
Clinical Assessment of the Incontinent Patient
87
Diagnosis of Fecal Incontinence
95
Imaging of Faecal Incontinence with Endoanal Ultrasound
106
Imaging of Fecal Incontinence
119
Invited Commentary
127
Invited Commentary
129
Diagnostic Workup in Incontinent Patients An Integrated Approach
135
Invited Commentary
148
Treatment of Fecal Incontinence
151
Patient Selection and Treatment Evaluation
152
Medical Treatment of Fecal Incontinence
163
Rehabilitation and Biofeedback
166
Sphincteroplasty
171
Invited Commentary
176
Postanal Pelvic Floor Repair
179
Dynamic Graciloplasty
184
Invited Commentary
190
Physiological Parameters Predicting the Outcome of Surgical and Nonsurgical Treatment of Fecal Incontinence
232
Selected Clinical Conditions
238
Rectal Resection
239
Iatrogenic Sphincter Lesions
251
Rectal Prolapse
260
Sphincter Atrophy
267
Obstetric Lesions The Coloproctologists Point of View
272
Obstetric Lesions The Gynaecologists Point of View
285
Neurogenic Fecal Incontinence
293
Diabetes
306
Fecal Incontinence in Elderly and Institutionalized Patients
317
Pelvic Radiotherapy
325
Double Incontinence
331
Invited Commentary
339
Pediatric Fecal Incontinence
341
Future Perspectives
351
Future Perspectives in Management and Research of Fecal Incontinence
352
Subject Index
359
Copyright

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About the author (2007)

CARLO RATTO. He was born in Neaples, July 6th, 1962. He was graduated in Medicine and Surgery at the Catholic University of Rome in 1987. Specialist in General Surgery.

He is Researcher at the Department of Clinica Chirurgica, Catholic University, Rome.

His clinical practice, at the Division of Chirurgia Digestiva, Department of Surgical Sciences of Catholic University, Rome (Policlinico "A. Gemelli"), concerns particularly the colo-recto-anal diseases. He is actively involved in research on: Colorectal cancer, in particular concerning diffusion modalities of the tumor and prognosis, integrated therapies (surgery, chemoradiation, intraoperative radiation therapy), molecular biology; Anal cancer, in particular concerning staging and restaging of the tumor, integrated therapies (chemoradiation); Anorectal physiology, in particular concerning anorectal manometry, electrophysiology studies, endoanal ultrasound in benign anorectal disorders; Fecal incontinence and constipation, in particular concerning, pathophysiology and treatment with traditional and novel therapeutic modalities (sphincteroplasty, dynamic graciloplasty, sacral neuromodulation); Fistula-in-ano, in particular concerning the assessment of fistula and abscess with endoanal ultrasound related to surgery results; Rectocele, in particular, concerning pathophysiology and modalities of clinical presentation, treatment options.

He is author of a number of scientific publications on international journals, and presented results of his research at national and international scientific meetings.

He is active member of: American Society of Colon and Rectal Surgeons (ASCRS); European Society of Coloproctology (EACP); Societą Italiana di Chirurgia (SIC); Societą Italiana di Chirurgia Oncologica (SICO); Societą Italiana di Chirurgia Colorettale (SICCR)

He is National Secretary of the Societą Italiana di Chirurgia Colorettale (SICCR)

He is National Scientific Secretary of the Italian Group for Sacral Neuromodulation (GINS).

 

GIOVANNI BATTISTA DOGLIETTO. He was born in Sparone (TO), April 17th, 1948. He was graduated in Medicine and Surgery at the Catholic University of Rome. Specialist in General Surgery and Urology.

He is the Chief of the Division of Digestive Surgery of "A. Gemelli" Hospital, and Ordinary Professor of General Surgery at Catholic University, Rome.

His clinical practice concerns particularly the colo-recto-anal diseases, as well as the other GI neoplasms and diseases. He is involved in the management of fecal incontinence. He is actively involved in research on GI diseases.

He is author of more than 500 scientific publications on national and international journals.

He is active member of: Societą Italiana di Chirurgia (SIC); Societą Italiana di Chirurgia Oncologica (SICO); Societą Italiana di Chirurgia Colorettale (SICCR)