Does perineal body thickness affect faecal incontinence in multiparous patients?

Background. Obstetric trauma is the most common cause of faecal incontinence in multiparous women. The literature has shown that women with obstetric trauma to the anal sphincter have decreased perineal body thickness (PBT). Objective. To determine the role of PBT in the assessment of this type of faecal incontinence in multiparous patients. Methods. Forty-four women with faecal incontinence, and 36 asymptomatic women who had had two or more previous deliveries, were investigated with endoanal ultrasonography from January to December 2016. The patients were divided into three groups on the basis of PBT: <10 mm, 10 - 12 mm and >12 mm. The degree of faecal incontinence was measured using the Wexner faecal incontinence score. Sphincter angle defect was separately measured for each patient. Results. The mean (standard error) age of all of our 80 patients was 46.9 (1.3) years (range 26 - 77 years), and the mean PBT in incontinent patients was 8.78 (2.84) mm, and 12.65 (16.76) mm in asymptomatic subjects (p<0.001). The mean Wexner score was 8.6(range 2 - 20) in incontinent patients. External anal sphincter defect angles were negatively correlated with PBT (p=0.045). For 89% of the patients, there was a history of vaginal delivery, and 62.5% had undergone one or more prior episiotomies during delivery. A PBT <10 mm was associated with sphincter defect in most incontinent patients. Conclusion. PBT plays a significantly important role in faecal incontinence, so it is recommended that it should be one of the factors involved in anal incontinency evaluations

Faecal Incontinence in Children in Calabar

Objective: To determine the prevalence of faecal incontinence in children in Calabar. Methods: A study of children who were admitted for faecal incontinence at the University of Calabar Teaching Hospital and the Faith Foundation Specialist Clinic in Calabar over a seven year period from January 1994 to December 200 was done. Results: Faecal incontinence in children was common as a result of previous anorectal surgery. The modal age at presentation was the 6 to 10 years age group; this corresponds with the time when the societal embarrassment of soilage at school became obvious. The expensive surgical operation for this condition was avoided as the patients were rather offered the simple conservative management consisting of diet manipulations; daily enema and training of sphincter muscles. To these was added a simple but effective surgical narrowing of the anorectal junction. This procedure complemented with psychotherapy was effective in improving continence to various degrees in 90of the patients. Conclusion: Faecal Incontinence is a societal problem and before school age is not taken seriously as diapers may be applied in the home environment