Kim M, Reibetanz J
Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.
Chirurg. 2020 Oct;91(10):870-877. doi: 10.1007/s00104-020-01206-7.
Traumatic anal sphincter muscle defects often occur after childbirth and surgery and can lead to fecal incontinence that requires further treatment.
The aim of this article is to illustrate the etiology of traumatic sphincter muscle defects, the treatment options of subsequent fecal incontinence and their evaluation on the basis of current studies.
Selected studies are presented.
Fecal incontinence presenting with a traumatic sphincter muscle defect is often due to multiple factors especially in the aged and makes the use of extended diagnostic tools necessary; however, the subjective complaints do not always correlate with morphological or functional diagnostic findings. Besides reconstructive procedures, such as sphincteroplasty and graciloplasty, sphincter augmentation techniques and sacral nerve stimulation can also be applied in traumatic sphincter muscle defects that are often associated with a loss of efficacy in the long term or a high rate of adverse events.
The fecal incontinence associated with traumatic sphincter insufficiency represents a diagnostic and therapeutic challenge due to the multifactorial origin. It is not uncommon that patients have to undergo several surgical and conservative interventions.
创伤性肛门括约肌缺损常发生于分娩及手术后，可导致大便失禁，需进一步治疗。
本文旨在根据当前研究阐述创伤性括约肌缺损的病因、后续大便失禁的治疗选择及其评估。
介绍所选研究。
伴有创伤性括约肌缺损的大便失禁通常由多种因素引起，尤其是在老年人中，因此需要使用多种诊断工具；然而，主观症状并不总是与形态学或功能诊断结果相关。除了重建手术，如括约肌成形术和股薄肌成形术外，括约肌增强技术和骶神经刺激也可应用于创伤性括约肌缺损，这类缺损常伴有长期疗效丧失或高不良事件发生率。
由于多因素起源，与创伤性括约肌功能不全相关的大便失禁是一个诊断和治疗挑战。患者不得不接受多次手术和保守干预的情况并不少见。
