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Solutions in anal incontinence and recto vaginal fistulas surgery in Bhubaneswar

Solutions in Anal incontinence and Recto Vaginal Fistulas Surgery

Solutions in anal incontinence and recto vaginal fistulas surgery in bhubaneswar

Dietary changes to control bowel movements, such as increasing fibre intake, may be part of the treatment for anal incontinence. The anal sphincter muscles can be strengthened with Pelvic Floor Exercises, Electrical Stimulation, and Biofeedback Therapy. Doctors may prescribe medications such as bulking agents or antidiarrheals to regulate bowel motions. Surgical procedures such as Sphincteroplasty or the implantation of an artificial anal sphincter may be taken into consideration to enhance continence in extreme circumstances. Depending on the severity of the symptoms such as bowel incontinence and the demands of the individual, a combination of these treatments is frequently used for management. 

Surgical intervention customised to the size, location, and underlying causes of rectovaginal fistulas is the standard of care. Techniques that may be used include: 

  • Seton Placement, which involves gradually cutting through the fistula tract with a suture or drain

  • Advancement Flap Repair, which involves directly incising and closing the fistula tract

  • Muscle Interposition, or Colostomy Diversion, is used in cases where the patient is not responding well to treatment. 

The goals of individualised treatment programmes are to seal the fistula, return vaginal and bowel function to normal, and guard against recurrence. 

With our expert lineup of general surgeons, we offer you the best solutions in anal incontinence and recto vaginal fistulas surgery in Bhubaneswar.

Explore advanced treatment options for anal incontinence and rectovaginal fistulas surgery in Bhubaneswar at Manipal Hospitals, ensuring effective care and improved quality of life.

FAQ's

Depending on the cause of faecal incontinence, options include: 

  • Anti-diarrhoea medications include atropine diphenoxylate (Lomotil) and loperamide (Imodium A-D)

  • Bulk laxatives such as methylcellulose (Citrucel) and psyllium (Metamucil) if chronic constipation is causing your incontinence

These therapies can enhance awareness of the urge to urinate as well as anal sphincter control: 

  • Kegel exercises: Kegel exercises are designed to strengthen the pelvic floor muscles and improve pelvic organ support, sexual function, and bladder control. 

  • Biofeedback: In the course of treating anal incontinence, Biofeedback provides real-time input to patients, assisting in the strengthening of pelvic floor muscles and enhancing bowel control. 

  • Bowel Training: Your doctor might advise you to try to schedule your bowel movements at a certain time of day, like just after you eat. You can improve your control by determining when to use the toilet. 

  • Bulking Agents: Nonabsorbable Bulking Agents can be injected into the anus to thicken its walls. This reduces the possibility of leaks.

  • Stimulation of the Sacral Nerve: Your spinal cord and the muscles in your pelvis are connected via the sacral nerves. Your anal and rectal sphincter muscles' strength and sensitivity are controlled by them. The gut muscles can be strengthened by implanting a device that stimulates the nerves with tiny electrical impulses. 

  • Stimulation of the Posterior Tibial Nerve: The posterior tibial nerve near the ankle is stimulated by this minimally invasive procedure. However, this treatment did not show a statistically significant improvement over a placebo in large-scale research. 

  • Vaginal Balloon (Eclipse System): This vaginally implanted device resembles a pump. The number of faecal incontinence episodes decreases as a result of the pressure exerted on the rectal region by the inflated balloon. 

Sphincteroplasty is a surgical technique used to treat faecal incontinence that involves strengthening or replacing the anal sphincter muscle. To restore strength and function, the sphincter muscle is meticulously rebuilt throughout the surgery, frequently with the use of tissue transplants or stitches. The goals of Sphincteroplasty are to lessen leaking episodes and enhance bowel control. Following surgery, pelvic floor exercises and rehabilitation are usually advised to maximise healing and the procedure's efficacy. 

To treat the fistula or prepare you for surgery, your healthcare professional might recommend the following medications:

  • Antibiotics: Before surgery, you can be prescribed a course of antibiotics if the region surrounding your fistula is contaminated. If you develop a fistula and have Crohn's disease, you may be prescribed antibiotics.

  • Infliximab: Crohn's disease-related fistulas can be healed and inflammation reduced with the use of infliximab (Remicade).

A rectovaginal fistula must typically be closed or repaired surgically. The skin and surrounding tissue of the fistula should be free of infection and irritation before surgery. A colorectal surgeon, gynaecological surgeon, or both operating in tandem may perform the surgery to close a fistula. The objective is to cut out the fistula tunnel and suture the healthy tissue together to seal the entrance.

Surgical alternatives consist of:

  • Removing the fistula: The anal and vaginal tissues are healed, and the fistula tunnel is eliminated. 

  • Applying a tissue substitute. The surgeon makes a flap from adjacent healthy tissue after removing the fistula. The flap conceals the fix. There are various options available that involve the use of tissue or muscle flaps from the rectum or vagina. 

  • Repairing the muscles of the anal sphincter. If there has been tissue injury or scarring from Crohn's disease, radiotherapy, vaginal delivery, or fistula, these muscles are repaired.

  • Doing a Colostomy before repairing a fistula in complex or recurrent cases: A Colostomy is a surgical operation where waste is redirected from your rectum through a hole in your abdomen. In extremely rare circumstances, a Colostomy may be required permanently or only temporarily. 

  • If you have experienced tissue damage or scarring from Crohn's disease, Radiation Therapy, or post-surgery, you might require a Colostomy. If you have a persistent infection or a lot of faeces coming through the fistula, you could need a Colostomy. A Colostomy may also be necessary for a malignant tumour or an abscess.

Your surgeon might preserve the Colostomy opening in the abdomen for three to six months. At that point, the Colostomy can be turned around so that stool once more travels via the rectum, if your doctor is certain that your fistula has healed.

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