Restoration of Fecal Continence After Functional Gluteoplasty
- 1 January 2006
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Plastic Surgery
- Vol. 56 (1), 65-71
- https://doi.org/10.1097/01.sap.0000186513.75052.29
Abstract
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. 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). 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). Despite a high incidence of donor-site and perirectal complications, unilateral functional gluteoplasty was successful in restoring long-term fecal continence in most patients.Keywords
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