The Electrically Stimulated Neoanal Sphincter and Colonic Conduit

Faecal incontinence affects about 2.2% of the population. Non-surgical interventions include dietary manipulation or the use of enemas and drug regimens. Surgical procedures such as anterior sphincter repair may improve function for the majority of patients, but for some a permanent stoma may be the only therapeutic option. A technique pioneered at the Royal London Hospital uses gracilis muscle augmentation combined with electrical stimulation to improve sphincter control. However, some patients experience residual evacuatory problems. Antegrade irrigation may be incorporated into the procedure, but both techniques can be used independently to promote continence. Although these procedures are still in a developmental stage, they are an option for a select group of patients who would otherwise be managed with a permanent stoma.