Fecal incontinence is a common problem among women, affecting between 2 and 7% of the general population. Although pelvic reconstructive surgeons have had many effective tools and techniques to treat other pelvic floor disorders, including pelvic organ prolapse and urinary incontinence, there has been a shortage of effective treatment options for fecal incontinence.
In the past few years, however, we have witnessed the introduction of several novel and intriguing treatments for this socially disabling condition. This renaissance of innovation speaks to the recognition that fecal incontinence is a significant pelvic floor disorder that we have not adequately addressed. Recent studies include research on a novel vaginal device to treat fecal incontinence, as well as long-term and comparative studies on neuromodulation, perianal bulking and transanal radiofrequency energy. There have also been recent studies on several novel, yet still unapproved, implantable devices, including a self-affixing rectal sling and a magnetic sphincter.
In the not-too-distant future, it appears that pelvic reconstructive surgeons will have a vast armamentarium of tools to manage one of the more vexing pelvic floor conditions we face in our daily practice. With the introduction of these new treatments, it will be important to develop a logical algorithm in our approach to fecal incontinence.
Division of Urogynecology and Reconstructive Pelvic Surgery, Mount Auburn Hospital, Cambridge
Department of Obstetrics and Gynecology, Harvard Medical School, Boston, Massachusetts USA
Correspondence to Peter Rosenblatt, Division of Urogynecology and Reconstructive Pelvic Surgery, Mount Auburn Hospital, 725 Concord Avenue, Suite 1200, Cambridge, MA 02138, USA. Tel: +1 617 354 5452; e-mail: firstname.lastname@example.org@mah.harvard.edu