Vaginal sacrospinous colpopexy and perineorrhaphy for faecal incontinence: preliminary report.

OBJECTIVE

To review our experience with vaginal sacrospinous colpopexy combined with perineorraphy performed for patients with genital prolapse who concomitantly suffered from faecal incontinence (FI).

SETTING

Gynaecology Department, Benenden Hospital, Benenden, Kent, UK.

SUBJECTS AND

METHODS

Between January 1997 and December 2001, 16 patients presented with symptoms of genital prolapse and faecal incontinence. Eleven out of the 16 patients (69%) had anorectal physiological tests and endoanal ultrasound performed before surgery. All patients had sacrospinous colpopexy and perineorraphy. Simultaneous vaginal hysterectomy was performed in two patients and anterior colporrhaphy in six patients.

RESULTS

The mean age was 60 years and median parity was 2. The mean operative time was 62 min (range 35-100) and the mean blood loss was 60 ml (range 30-160). The mean follow-up period was 37 months (6-65). Thirteen patients (81%) reported no faecal incontinence after surgery, and two patients (12.5%) reported improvement. One patient (6.5%) had no improvement in her symptom of faecal incontinence after surgery. None of the patients had recurrence of genital prolapse during follow up.

CONCLUSION

Sacrospinous colpopexy combined with perineorraphy can help to cure symptoms of faecal incontinence associated with genital prolapse. The possible mechanisms for such a favourable result are discussed.