Abstract
Purpose: For patients with severe fecal incontinence, reconstruction of the anal sphincter, via gluteoplasty, may improve quality of life, but little is known about long-term functional results. We present our comprehensive experience with gluteoplasty, highlighting technical refinements, donor-site morbidity, and functional outcomes. Methods: We performed a retrospective analysis of 25 consecutive patients (22 female, 3 male; mean age 42 years, range 23-65) undergoing gluteoplasty for fecal incontinence at a university teaching hospital from 1996-2004. Etiology of incontinence was as follows: obstetrical injury (n = 13), irritable bowel syndrome (n = 3), previous rectal surgery (n = 3), Crohn disease (n = 3), impalement (n = 1), rectocele (n = 1), and idiopathic (n = 1). Results: Gluteoplasty was successful in restoring fecal continence in 18 patients (72%) and was partially successful in 4 patients (16%). Two patients required permanent ostomy because of refractory incontinence. Donor-site morbidity and perirectal complications were observed in 16 patients (64%) and included dysthesias (n = 7), cellulitis (n = 5), irregular contour (n = 3), abscess (n = 2), seroma (n = 2), fistula (n = 1), but no hip dysfunction or altered gait. Mean length of follow-up was 20.6 months (range: 3-68 months). Conclusions: Despite a high incidence of donor-site and perirectal complications, unilateral functional gluteoplasty was successful in restoring long-term fecal continence in most patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 65-71 |
| Number of pages | 7 |
| Journal | Annals of plastic surgery |
| Volume | 56 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2006 |
| Externally published | Yes |
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Keywords
- Fecal incontinence
- Gluteoplasty
ASJC Scopus subject areas
- Surgery
Cite this
Restoration of fecal continence after functional gluteoplasty : Long-term results, technical refinements, and donor-site morbidity. / Hultman, C. Scott; Zenn, Michael R.; Agarwal, Tripti; Baker, Christopher C.; Friedman, Harold I.; Merritt, Wyndell H.; Hagan, Kevin F.
In: Annals of plastic surgery, Vol. 56, No. 1, 01.01.2006, p. 65-71.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Restoration of fecal continence after functional gluteoplasty
T2 - Long-term results, technical refinements, and donor-site morbidity
AU - Hultman, C. Scott
AU - Zenn, Michael R.
AU - Agarwal, Tripti
AU - Baker, Christopher C.
AU - Friedman, Harold I.
AU - Merritt, Wyndell H.
AU - Hagan, Kevin F.
PY - 2006/1/1
Y1 - 2006/1/1
N2 - Purpose: For patients with severe fecal incontinence, reconstruction of the anal sphincter, via gluteoplasty, may improve quality of life, but little is known about long-term functional results. We present our comprehensive experience with gluteoplasty, highlighting technical refinements, donor-site morbidity, and functional outcomes. Methods: We performed a retrospective analysis of 25 consecutive patients (22 female, 3 male; mean age 42 years, range 23-65) undergoing gluteoplasty for fecal incontinence at a university teaching hospital from 1996-2004. Etiology of incontinence was as follows: obstetrical injury (n = 13), irritable bowel syndrome (n = 3), previous rectal surgery (n = 3), Crohn disease (n = 3), impalement (n = 1), rectocele (n = 1), and idiopathic (n = 1). Results: Gluteoplasty was successful in restoring fecal continence in 18 patients (72%) and was partially successful in 4 patients (16%). Two patients required permanent ostomy because of refractory incontinence. Donor-site morbidity and perirectal complications were observed in 16 patients (64%) and included dysthesias (n = 7), cellulitis (n = 5), irregular contour (n = 3), abscess (n = 2), seroma (n = 2), fistula (n = 1), but no hip dysfunction or altered gait. Mean length of follow-up was 20.6 months (range: 3-68 months). Conclusions: Despite a high incidence of donor-site and perirectal complications, unilateral functional gluteoplasty was successful in restoring long-term fecal continence in most patients.
AB - Purpose: For patients with severe fecal incontinence, reconstruction of the anal sphincter, via gluteoplasty, may improve quality of life, but little is known about long-term functional results. We present our comprehensive experience with gluteoplasty, highlighting technical refinements, donor-site morbidity, and functional outcomes. Methods: We performed a retrospective analysis of 25 consecutive patients (22 female, 3 male; mean age 42 years, range 23-65) undergoing gluteoplasty for fecal incontinence at a university teaching hospital from 1996-2004. Etiology of incontinence was as follows: obstetrical injury (n = 13), irritable bowel syndrome (n = 3), previous rectal surgery (n = 3), Crohn disease (n = 3), impalement (n = 1), rectocele (n = 1), and idiopathic (n = 1). Results: Gluteoplasty was successful in restoring fecal continence in 18 patients (72%) and was partially successful in 4 patients (16%). Two patients required permanent ostomy because of refractory incontinence. Donor-site morbidity and perirectal complications were observed in 16 patients (64%) and included dysthesias (n = 7), cellulitis (n = 5), irregular contour (n = 3), abscess (n = 2), seroma (n = 2), fistula (n = 1), but no hip dysfunction or altered gait. Mean length of follow-up was 20.6 months (range: 3-68 months). Conclusions: Despite a high incidence of donor-site and perirectal complications, unilateral functional gluteoplasty was successful in restoring long-term fecal continence in most patients.
KW - Fecal incontinence
KW - Gluteoplasty
UR - http://www.scopus.com/inward/record.url?scp=29944436867&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=29944436867&partnerID=8YFLogxK
U2 - 10.1097/01.sap.0000186513.75052.29
DO - 10.1097/01.sap.0000186513.75052.29
M3 - Article
C2 - 16374099
AN - SCOPUS:29944436867
VL - 56
SP - 65
EP - 71
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
SN - 0148-7043
IS - 1
ER -