الفهرس 
Pelvic FloorOnly 14 pages are availabe for public view
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Abstract
Prokinetic drugs as Cisapride which is serotonin 5HT4 agonist stimulates gastrointestinal motility throughout the gastrointestinal tract, but in recent studies no difference was detected between Cisapride and placebo in facilitating bowel evacuation.
Rehabilitative treatment for fecal incontinence is a good therapeutic option and many patients may be cured and their quality of life much improved. In addition, rehabilitation techniques can be used to screen out the incontinent non responders, whose treatment should more appropriately include more expensive and extensive procedures (e.g., sphincteroplasty, sacral neuromodulation, artificial sphincter, dynamic graciloplasty)
Surgical treatment comes after failure of the non surgical options an includes;
- Malone Antegrade Continence Enema through small appendicostomy which has been used in several studies among children with spina bifida with Generally success rate between 50 and 90% and in two small studies among adult patients with constipation or faecal incontinence due to lesions of the central nervous system, bowel function improved in 84% and 87% of patients respectively.
- Postanal repair is currently performed on patients with neuropathic faecal incontinence with no evidence of sphincter defect on endoanal ultrasound.
- Dynamic Graciloplasty by Transposition of the gracilis muscle to replace the anal sphincter acts as a mechanical sling and prevent faecal soiling but by itself, the muscle is incapable of constant voluntary contraction or relaxation.
- Artificial sphincter by totally implantable device made of solid silicone rubber with satisfying results in short and medium term follow-up (about 70%) but less than 50% in a longer follow up.
-Lastly Sacral Nerve Stimulation can recruit residual function of an inadequate anorectal continence organ by electrostimulation of its peripheral nerve supply with high successful rats