This book is aimed at all physicians involved in the assessment and treatment of fecal incontinence. Its main purpose is to review the latest advances in the epidemiologic, socio-economic, psychologic, diagnostic, and therapeutic aspects of fecal incontinence, in order to establish guidelines for effective treatment. Fecal incontinence is a frequent, distressing condition that has a devastating impact on patients' lives. However, patients are typically embarrassed and reluctant to acknowledge this disability, so they relinquish the possibility of being cured and remain socially isolated. Since fecal incontinence may result from various pathophysiological situations, an accurate diagnostic work-up of each patient is fundamental. Today, a wide range of therapeutic options is available, but making the correct choice is pivotal to the successful management of this condition.

Autorentext

CARLO RATTO. He was born in Neaples, July 6th, 1962. He was graduated in Medicine and Surgery at the Catholic University of Rome in 1987. Specialist in General Surgery.

He is Researcher at the Department of Clinica Chirurgica, Catholic University, Rome.

His clinical practice, at the Division of Chirurgia Digestiva, Department of Surgical Sciences of Catholic University, Rome (Policlinico "A. Gemelli"), concerns particularly the colo-recto-anal diseases. He is actively involved in research on: Colorectal cancer, in particular concerning diffusion modalities of the tumor and prognosis, integrated therapies (surgery, chemoradiation, intraoperative radiation therapy), molecular biology; Anal cancer, in particular concerning staging and restaging of the tumor, integrated therapies (chemoradiation); Anorectal physiology, in particular concerning anorectal manometry, electrophysiology studies, endoanal ultrasound in benign anorectal disorders; Fecal incontinenceand constipation, in particular concerning, pathophysiology and treatment with traditional and novel therapeutic modalities (sphincteroplasty, dynamic graciloplasty, sacral neuromodulation); Fistula-in-ano, in particular concerning the assessment of fistula and abscess with endoanal ultrasound related to surgery results; Rectocele, in particular, concerning pathophysiology and modalities of clinical presentation, treatment options.

He is author of a number of scientific publications on international journals, and presented results of his research at national and international scientific meetings.

He is active member of: American Society of Colon and Rectal Surgeons (ASCRS); European Society of Coloproctology (EACP); Società Italiana di Chirurgia (SIC); Società Italiana di Chirurgia Oncologica (SICO); Società Italiana di Chirurgia Colorettale (SICCR)

He is National Secretary of the Società Italiana di Chirurgia Colorettale (SICCR)

He isNational Scientific Secretary of the Italian Group for Sacral Neuromodulation (GINS).

GIOVANNI BATTISTA DOGLIETTO. He was born in Sparone (TO), April 17th, 1948. He was graduated in Medicine and Surgery at the Catholic University of Rome. Specialist in General Surgery and Urology.

He is the Chief of the Division of Digestive Surgery of "A. Gemelli" Hospital, and Ordinary Professor of General Surgery at Catholic University, Rome.

His clinical practice concerns particularly the colo-recto-anal diseases, as well as the other GI neoplasms and diseases. He is involved in the management of fecal incontinence. He is actively involved in research on GI diseases.

He is author of more than 500 scientific publications on national and international journals.

He is active member of: Società Italiana di Chirurgia (SIC); Società Italiana di Chirurgia Oncologica (SICO); Società Italiana di Chirurgia Colorettale (SICCR)

Zusammenfassung

Fecal incontinence is a frequent, distressing condition that has a devastating impact on patients' lives. However, patients are typically embarrassed and reluctant to acknowledge this disability, so they relinquish the possibility of being cured and remain socially isolated. Since fecal incontinence may result from various pathophysiological situations, an accurate diagnostic work-up of each patient is fundamental. Today, a wide range of therapeutic options is available, but making the correct choice is pivotal to the successful management of this condition. This book is aimed at all physicians involved in the assessment and treatment of fecal incontinence. Its main purpose is to review the latest advances in the epidemiologic, socio-economic, psychologic, diagnostic, and therapeutic aspects of fecal incontinence, in order to establish guidelines for effective treatment.

Inhalt
Structure and Function in Continence and Incontinence.- Anatomy and Physiology of Continence.- Epidemiology of Faecal Incontinence.- Pathophysiology of Faecal Incontinence.- Risk Factors in Faecal Incontinence.- Psychological Aspects of Faecal Incontinence.- Impact of Fecal Incontinence on Quality of Life.- Social Aspects and Economics of Fecal Incontinence.- Diagnosis of Fecal Incontinence.- Clinical Assessment of the Incontinent Patient.- Diagnosis of Fecal Incontinence.- Imaging of Faecal Incontinence with Endoanal Ultrasound.- Imaging of Fecal Incontinence.- Diagnostic Workup in Incontinent Patients: An Integrated Approach.- Treatment of Fecal Incontinence.- Patient Selection and Treatment Evaluation.- Medical Treatment of Fecal Incontinence.- Rehabilitation and Biofeedback.- Sphincteroplasty.- Postanal Pelvic Floor Repair.- Dynamic Graciloplasty.- The Artificial Bowel Sphincter in the Treatment of Severe Fecal Incontinence in Adults.- Gluteoplasty for the Treatment of Fecal Incontinence.- Sacral Nerve Stimulation.- Injectable Bulking Agents.- Radiofrequency.- Physiological Parameters Predicting the Outcome of Surgical and Nonsurgical Treatment of Fecal Incontinence.- Selected Clinical Conditions.- Rectal Resection.- Iatrogenic Sphincter Lesions.- Rectal Prolapse.- Sphincter Atrophy.- Obstetric Lesions: The Coloproctologist's Point of View.- Obstetric Lesions: The Gynaecologist's Point of View.- Neurogenic Fecal Incontinence.- Diabetes.- Fecal Incontinence in Elderly and Institutionalized Patients.- Pelvic Radiotherapy.- Double Incontinence.- Pediatric Fecal Incontinence.- Future Perspectives.- Future Perspectives in Management and Research of Fecal Incontinence.