Results of conservative and surgical therapy of anal incontinence. 1974 to 1992 patient sample

: Data from 235 patients (189 women, 46 men) from 1974 to 1993 were analyzed for examining therapeutic success of operative and conservative treatment of anorectal incontinence. Clinical, manometric, electrophysiological and radiological examinations were performed for checking the functional results. In the group of 134 operated patients, the preoperative incontinence score (according to Kelly-Holischneider) of 6.7 points could be improved to 9.9 points. 50% of the operations were direct anatomical sphincter reconstructions, in which continence could be completely reestablished in 85% of the cases. Further procedures for improving continence included post-anal repair (n = 20), transabdominal rectopexy (n = 24) and gracllis grafting (n = 11). 147 patients were conservatively treated using electrostimulation (n = 75) and biofeedback training (n = 72). Irregardless of existing degree of incontinence, recovery was clinically as well as manometrically obtained in 39% and an improvement of symptoms in 38%.