Surgical Management of Fecal Incontinence

Fecal incontinence is a common yet socially stigmatized condition that results from a complex interplay of various etiologies. In commonly seen scenarios, obstetric injuries can result in fecal incontinence after assisted or uncomplicated vaginal births and can become symptomatic years after delivery. Postpartum women may initially present to their obstetrician-gynecologist or urogynecologist with fecal incontinence symptoms and require appropriate evaluation, initial management, and possible referral to further specialists. This chapter outlines the surgical assessment, work-up, and management of fecal incontinence. This review contains 21 figures, 1 tables, and 97 references. Keywords: Fecal incontinence, postpartum complications, pudendal nerve neuropathy, anal sphincter injury, operative management, preoperative workup, sacral nerve stimulation, MRI defecography, endanal ultrasound