Neurostimulation for fecal incontinence after correction of repair of imperforate anus

摘要

We are reporting the case of a 32-year-old female who had suffered from fecal incontinence(FI).She was born with an imperforate anus and a recto-vaginal fistula;she underwent repair at 6 mo of age.At 29 years of age,she was still fecally incontinent despite extensive pelvic floor reeducation.A magnetic resonance imaging and an anal electromyography were performed.Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus,a redo was performed of the recto-neo-anal intra-sphincteric anastomosis.A neurostimulator device was subsequently implanted for persistent incontinence.Solid and liquid FI resolved,and her quality of life improved markedly.Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn.Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.