Patient Education
Fecal Incontinence
Treatments
Radiofrequency:
A unique radiofrequency therapy known as Secca™ received FDA approval for treatment of fecal incontinence in 2002. The thermal energy is used to tighten the anal sphincter. This treatment is helpful for patients with mild incontinence.
Sphincteroplasty:
This surgical procedure repairs a damaged sphincter muscle by overlapping and sewing the muscle at the defect site. This treatment is helpful for patients with mild to severe incontinence.
Levator Plication:
This is surgery performed through a vaginal incision in patients found to be with a hernia of the wall between the vagina and rectum. This hernia is also called a rectocele. This surgical procedure repairs the hernia. Stitches are placed in the tissue between the vaginal wall and the rectum to add support and help to reposition the rectum into its normal position. This procedure isoften helpful in those who push with a finger to help make a bowel movement.
Rectovaginal Fistula Repair:
A rectovaginal fistula, a hole or tunnel between the vagina and rectum, is an unusual cause of fecal incontinence. It may result from previous vaginal surgery, traumatic childbirth, hysterectomy, bowel surgery, infection, or inflammatory bowel disease. Rectovaginal fistual repair is a surgery typically performed through a vaginal incision
Bulking Agent Injections:
Material may be injected into the area of the anus in order to "tighten" or partially close it. This narrows the anal canal resulting in improved control for many women. This treatment is helpful for patients with mild incontinence. Bulking agent injections typically last six months to two years and can be repeated as needed.
There are many different materials which are used for injection. The most common are Coaptite® (calcium hydroxylapatite), Macroplastique® (silicone), and Durasphere® (pyrolytic carbon-coated beads). Although the later three have been touted to last longer than Contigen®, this has not been our experience. We have found Contigen® to provide the highest cure rate from a single injection. Injection is also extremely well tolerated in the office setting. The average time to complete this procedure is just three minutes.
Solesta®
When changes in diet and medication do not give you the results you are looking for, Solesta provides an effective treatment option for fecal incontinence. Our practice performs more Solesta injections than any other urogynecologist in Florida. Dr. Zipper serves on the serves on the National Solesta Advisory Committee. Made of naturally occurring components dextranomer and sodium hyaluronate, Solesta gel treatment is administered through four injections into the wall of the anal canal. Once injected, Solesta offers improved bowel control by bulking up the tissue in the anal canal. The Solesta injection is a nonsurgical, outpatient procedure that is performed in an area of the anal canal with minimal sensation The entire procedure is performed in our office in less than 10 minutes. Typically, maximum benefit is seen within three months following treatment. Our patients resume all normal lifestyle and physical activities after one week of Solesta treatment.
Electrical Stimulation Therapy
In patients who are unable to carry out effective pelvic muscle rehabiliation via biofeedback, E-Stim may be beneficial. A mild, painless electrical stimulus is delivered directly to the anus and pelvic floor muscles causing them to contract. This stimulus is delivered via a tampon-like sensor placed into the vagina or rectum. This treatment is helpful for patients with mild incontinence as well as constipation.
Biofeedback:
Biofeedback therapy reinforces the correct use of the pelvic muscles using computer images. A small tampon-like sensor placed into the vagina or rectum connects you to a computer and screen. Contracting and relaxing the pelvic floor muscles produces signals on the screen, allowing us to identify proper or improper technique. We can then use those same computer images to teach you to contract the anus and relax the abdomen. Many women who fail Kegel exercises respond to biofeedback therapy gaining control of their gas and bowel movements This treatment is helpful for patients with mild incontinence.
Drug Therapy:
In some cases medications may be helpful. Examples include medications often used to treat diarrhea. This treatment is helpful for patients with mild incontinence.
Dietary Changes:
Certain foods, such as dairy products, may trigger loose stools. Avoiding these foods may help prevent loss of control.However, more complex dietary modifications are often necessary for those with unrecognized intolerance to common foods. This treatment is helpful for patients with mild incontinence.
