In Case of Re-Education Failure, Should Postanal Repair Be the Treatment of Idiopathic Fecal Incontinence?

In a group of 22 patients with idiopathic fecal incontinence treated by postanal repair (PAR), functional results were determined with a postoperative interval of 3 and 34 ± 9 months. Incontinence was reduced in 10 patients, and 12 regained normal continence. In all patients, continent or not, pre- and postoperative studies (3 months after PAR) showed no modification of maximum resting pressure and of anal canal length while in continent patients, maximal voluntary contraction values were higher without being significant. Comparison of preoperative and 3-month postoperative defecographic X-rays showed no modification of either anorectal angle values, or of perineal descent. Isolated repair of striated sphincteric muscles, without internal sphincter repair, could result in the absence of resting pressure variation, and explain the lack of incontinence correction in 10 of our patients.