During the study period, 574 patients were referred to our third referral centre with the main symptoms of FI (16% males and 84% females). The mean age at presentation was 57 years old (Male median age 55, range 17-85; Female median age 58, range 20-93).
Fourteen percent of females were nulliparous, among the remaining parous females, the median number of vaginal deliveries was 3 (range 1-8). History of episiotomy or traumatic vaginal delivery was recorded in 269 (47%). 237 (41%) of patients who had a previous abdominal and/or transvaginal hysterectomy.
Past surgical events of potential etiological were present in 25% male and 25% female. Males had a lower incidence of previous pelvic floor surgery (M:1.1% vs F:19%, P<0.05). Males had a higher incidence of previous anal surgery (M:25%vs F: 8% p<0.05).
Incontinence symptoms could be divided into, urge faecal incontinence 65%, soiling 17%, passive faecal incontinence 11%, urgency 4% and 3% flatus incontinence. Although patient’s primary complaint was FI, 26% of subjects reported defaecatory difficulties classified as ODS.
Interventions are summarized in table 1. 81% have been sent for tests, out of them 98% had EAUS, 39% had PFUS, 97% had anorectal physiology and 82% had proctography.
Ninety-one percent of patients had conservative treatment, with an average number of biofeedback appointments 3 (range 1-13), which includes dietary advices, pelvic floor exercises, medications to increase stool consistency (41%), use of suppositories (51%) and selective use of low and high volume of irrigation (26%) .
Nine percent of patients had surgical interventions, in the form of laparoscopic ventral mesh rectopexy to correct high grade intussusception (30%), transvaginal rectocoele repair manage symptomatic rectocoele causing vaginal prolapse symptoms associated with ODS symptoms and soiling (24%), sacral neuromodular implant to improve urge faecal incontinence symptoms (9%), perineal rectopexy (7%), injection of bulking agents (5%), sphincter repair with rectocoele repair and levator-plasty to restore the anatomy of sphincter function and perineal body (4%), perineal rectosigmoidectomy (2%), sutured anopexy (2%), laparoscopic posterior rectopexy (2%), transperineal rectocoele repair (2%). Other procedures were performed for treatment of haemorrhoids in 13% of patients.