Fecal incontinence - Challenges and solutions

Table 6 Overview of various surgical options with respective outcomes (as detailed in the text)

Interventions category	Specific technique	Efficacy rate (complete/> 50% improvement)	Complication rates	Grade
Correction of morphological abnormalities	Depending on underlying condition:	N/A	N/A	N/A
	Prolapse, cloaca, keyhole deformity, perirectal fistula, rectovaginal fistula, tumor
Sphincter repair	Overlapping sphincteroplasty	75%-85% (short term)	N/A
		0-50% (after 5-10 yr)
Enhancement of sphincter function	Sacral nerve stimulation	0%-56%/51-100%	lead displacement (15%), diarrhea (6%), pain (6-28%), bleeding 11%, infection (3%)	1B
	Tibial nerve simulation	0%-12% (-40%)/0%-67%	59% (infection, mild gastrodynia, temporary leg numbness)	2C
	Radiofrequency energy administration	0%/12%-38% (-84%)	0%-52% (pain, bleeding, infection)	2B
	Injection of:	0%/33%-90%	10%-12% (pain, bleeding, infection)	2A
	conventional bulking agents	6%/56%-61%
	NASHA/DX
Sphincter replacement	Artificial bowel sphincter	61%-90%/31%-100%	5%-10% infection rates, 30%-52% long-term failure 9	1B
	Implantation of magnetic ring (Fenix™)	NA/54%	0%-7% obstruction, infection, erosion	1C
	Graciloplasty (dynamic/non-dynamic)	NA/72%	> 40% including urinary tract infection/retention, infections 76	2C
	Implantation of Thiersch	N/A	N/A	N/A
	Pelvic floor repairs/sling	19%/69.1%	17%-30% (pain, infection)	2C
Fecal diversion	Ileostomy, loop colostomy, end colostomy	near 100% FI improvement	5%-10% stoma outlet obstruction, stricture, prolapse, hernia	1C
Fecal load reduction	Malone antegrade continence enema	(0%)/33%-100% FI continence	8%-50% stoma stenosis, leakage	2C