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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]
Trauma !
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]
MRI Normal Anterior defect IAS & EAS
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.
Injectable Agents
Sacral Nerve Stimulation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SNS
Dynamic Graciloplasty ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dynamic Graciloplasty
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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