Reoperative surgery for fecal incontinence

Recent studies showed that in the United States approximately 19% females-aged ≥45 years-have had at least 1 episode of FI, with severe impact on quality of life. Complex integration and synergy among sphincter muscles, the pelvic floor, rectal compliance, and sensory function need to co-exist in order to maintain effective continence. When the function of any of these “compartments” is damaged bowel control becomes suboptimal and may worsen with time. The overall success rate of surgery for FI varies between 30% and 80% and progressively worsens with patient age. The aim of this article is to review and discuss the surgical strategies available for patients who no longer benefit from their initial surgical treatment for FI, and who require a redo intervention in order to overcome an immediate complication or a loss of effect.