Stimulation For Faecal Incontinence

The prevalence of fecal incontinence is approximately 5% in the general population. In all patients, the treatment of fecal incontinence is primarily conservative and surgery is offered as second line treatment. Electrical stimulation of the sacral nerves (SNS) with an implanted electrode is a minimally invasive and effective treatment of idiopathic FI and the indications for SNS are widening. However, SNS requires surgery while percutaneous electrical stimulation of peripheral nerves could be a non-invasive alternative. Stimulation for Faecal Incontinence comprises five studies. Study I examines the clinical effectiveness of transcutaneous stimulation. Study II and III examined the acute effect of rectal stimulation in idiopathic incontinent patients and patients with spinal cord injury. In study IV the validity of a new research tool for assessment of gastrointestinal motility during stimulation is evaluated. In study V, small intestinal motility is investigated in patients implanted with a sacral nerve stimulator for faecal incontinence. Based on the present book it can be concluded that: DGN stimulation reduces faecal incontinence in patients with idiopathic faecal incontinence but the mode of action remains unknown. DGN does not affect rectal wall properties in patients with idiopathic faecal incontinence. DGN increases rectal tone in patients with supraconal spinal cord injury, but the validity and clinical importance of the finding need further study. MTS-1 is useful for determination of gastric emptying and small intestinal transit time. Preliminary results indicate that SNS does not affect small intestinal motility, but data need further analysis and have to be confirmed in a larger study.

This excellent textbook provides up-to-date information on all aspects of pelvic floor disorders. After an opening section on anatomy and physiology, it explains the methodology, role and application of the integrated imaging approach in detail, including the most advanced 3D, 4D, and dynamic ultrasound techniques, illustrated with hundreds of images. It then discusses in depth the epidemiology, etiology, assessment, and management of the full range of pelvic floor disorders from multidisciplinary and practical perspectives. The book also provides information on the various forms of obstetric perineal trauma, urinary incontinence and voiding dysfunction, anal incontinence, pelvic organ prolapse, constipation and obstructed defecation, pelvic pain and sexual dysfunction, and fistulas, and includes treatment algorithms as well as helpful guidance on what to do when surgical treatment goes wrong. The authors are leading experts in the field from around the globe. Since the first edition from 2010 (more than 200,000 chapter downloads), the book has been extensively rewritten and features numerous additional topics. The result is a comprehensive textbook that is invaluable for gynecologists, colorectal surgeons, urologists, radiologists, and gastroenterologists, beginners and veterans alike.

Textbook of Surgery is a core book for medical and surgicalstudents providing a comprehensive overview of general andspeciality surgery. Each topic is written by an expert in thefield. The book focuses on the principles and techniques of surgicalmanagement of common diseases. Great emphasis is placed onproblem-solving to guide students and junior doctors through theirsurgical training. Throughout the book are numerous reproducible line drawings,tables and boxes that will prove invaluable for learning andrevision. In addition there are detailed guidelines provided forsurgical management. Up-to-date and ideal for medical students and junior doctors onsurgical attachments and a perfect refresher for RACS and MRCScandidates. Reviews of the last edition “The textbook presents a compact and contemporary overviewand is not so much a reference book as a working tome suitable forfamiliarization with current trends in treatment and diagnosis inthese various areas. …found this textbook very informative and a pleasure toread.” ANZ Journal of Surgery Vol. 72, No. 12.

The book surveys the prevalence, the pathophysiology, the diagnosis, the current therapy, both conservative and operative, and the long-term outcome of treatment of urinary and fecal incontinence. It is targeted at general and colorectal surgeons, urologists, gynecologists and gastroenterologists who treat incontinent patients, and also gives general practitioners and geriatric physicians an overview of the diagnostic methods and treatment options that can be offered to incontinent patients.

This book presents state of the art knowledge regarding the pathophysiology and diagnosis of fecal incontinence and describes and illustrates all relevant treatment techniques. In addition to the approaches that have been the mainstay of treatment of fecal incontinence to date, it covers recent innovations and emerging options, including neurostimulation, pioneering techniques exploiting the potential of stem cells, biofeedback training, reconstructive surgery, and advances in biomedical engineering applicable to replacement surgery. Fecal incontinence is a common, socially debilitating disorder of multifactorial etiology that poses many management challenges. This book will assist all relevant medical specialists, including surgeons, neurologists, gastroenterologists, urogynecologists, and other clinicians, in achieving correct and timely diagnosis and delivering effective therapy that reflects the ongoing revolution in treatment.

This book will enable the reader to gain a sound understanding of contemporary and futuristic evidence-based interventions and assessment procedures for pelvic floor disorders. It gathers the experiences of some of the most important experts on electrical stimulation techniques, offering a multidisciplinary and problem-oriented approach organized according to therapeutic goals. Interventions are recommended that are consistent with theory and display clinical efficacy for specific disorders, including urinary incontinence or retention, fecal incontinence, constipation, pelvic pain, sexual dysfunction and neurological diseases involving the pelvic floor. All of the surgical or rehabilitative techniques requiring electrical stimulation for the treatment of these disorders are explored and essential background information is provided on functional anatomy, neurophysiology and concepts in electrotherapy. This volume will be a very useful tool for urologists, general or colorectal surgeons, gynecologists and anesthesiologists and also physiotherapists and alternative medicine practitioners (a specific chapter focuses on electroacupuncture). It will assist in their clinical practice as they seek to help the very many patients who suffer from any of the wide range of functional pelvic floor disorders.