Faecal IncontinenceCauses, Diagnosis, & Contemporary Treatment

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Faecal Incontinence Causes, Diagnosis, & Contemporary Treatment Mr Darren TONKIN Colorectal Surgeon Adelaide SA

Faecal Incontinence ,[object Object],Whitehead et al. Functional disorders of the anus and rectum. Gut 1999; 45 (Suppl II): II55–9

Normal Continence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incontinence - Types ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Functional ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sphincter Defect ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Obstetric Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ANZJS, 1999; 69: 172-7

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Assessment - History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cleveland Clinic Scoring System 4 3 2 1 0 LIFESTYLE ALTERATION 4 3 2 1 0 USE OF PAD 4 3 2 1 0 FLATUS 4 3 2 1 0 LIQUIDS 4 3 2 1 0 SOLIDS ALWAYS USUALLY SOMETIMES RARELY NEVER

Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Endoanal US Normal Anterior defect IAS & EAS

MRI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Manometry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conservative Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stop straining Stronger squeeze Longer duration Am J Gastro 2000; 95(8): 1873-80 Biofeedback

Topical Phenylephrine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Surgery Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Anterior Sphincter Repair ,[object Object],[object Object],[object Object],[object Object],Hull et al. DCR 2002; 45: 345-8

Injectable Agents ,[object Object],[object Object],[object Object],[object Object],[object Object],Tjandra et al. DCR 2004.

Sacral Nerve Stimulation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dynamic Graciloplasty ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Artificial Bowel Sphincter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Artificial Bowel Sphincter ,[object Object],[object Object]

Stoma ,[object Object],[object Object],[object Object],[object Object]

Faecal Incontinence Non-operative treatment Success Failure Investigate ESD Direct repair Neurogenic ISD Injectable Injectable Sacral nerve Gracilis / Artificial Stoma

Conclusion ,[object Object],[object Object],[object Object]

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