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Surgical treatment of anal incontinence and recto vaginal fistulas-Bhubaneswar

Surgical Treatment of Anal Incontinence and Rectovaginal Fistulas

Surgical treatment of anal incontinence and recto vaginal fistulas in Bhubaneswar

Increasing bowel control and sphincter function is the aim of surgical treatment for anal incontinence. Options include Sphincteroplasty (which repairs damaged anal muscles), prosthetic sphincters (which provide mechanical support), and Sacral Nerve Stimulation (which modifies the nerve signals that control bowel function). The tissue surrounding the anus is expanded by injectable anal bulking agents. When developing these techniques, the underlying cause and severity of incontinence are taken into consideration. The preoperative evaluation, which includes imaging and anal manometry, directs the choice of treatment. Surgery can greatly improve a patient's health, but patient selection and postoperative care are essential for optimal outcomes.

Different surgical techniques are used to treat rectovaginal fistulas, depending on their size, location, and underlying reasons. Techniques that may be used include Seton Placement (which involves gradually cutting through the fistula tract with a suture or drain), Advancement Flap Repair (involves directly incising and closing the fistula tract), and more intricate methods like Muscle Interposition or Colostomy Diversion in cases where the patient is not responding well to treatment. To heal the fistula, restore normal bowel and vaginal function, and prevent recurrence, surgical management is typically necessary. This means that treatment strategies must be customised to each patient's unique demands and condition. With our expert lineup of general surgeons, we offer you the best surgical treatment of anal incontinence and recto vaginal fistulas in Bhubaneswar.

Discover advanced surgical solutions for anal incontinence and rectovaginal fistulas at Manipal Hospitals in Bhubaneswar. Expert care for rectal health concerns.

FAQ's

A total loss of control over one's bowel movements and sporadic stools leaking while passing gas is termed faecal incontinence or bowel incontinence. Constipation, muscular or nerve injury, and diarrhoea are common causes of faecal incontinence. The injury to the muscles or nerves could be brought on by ageing or childbirth. It can be challenging to talk about faecal incontinence, regardless of the cause. However, don't be afraid to discuss this frequent issue with your doctor. Both your quality of life and faecal incontinence can be enhanced by treatments. 

Faecal incontinence complications can include:

  • Emotional distress: An individual might become uncomfortable about losing control over their body in public. Individuals who experience faecal incontinence may attempt to conceal the issue or steer clear of social situations.

  • Inflammation of the skin: The anus's surrounding skin is fragile. Regular stool contact may cause discomfort and itching. Ulcers, commonly known as sores, may also develop in the area. Medical care is frequently necessary for ulcers.

Anal incontinence procedures may result in surgical problems such as:

  • Infection: Infections at surgical sites can result in discomfort, oedema, and possibly even a systemic disease.

  • Bleeding: Intervention is necessary to stop bleeding if it occurs during or after surgery.

  • Faecal impaction: Surgical scars or anatomical changes may make it difficult to pass the stool.

  • Anal stenosis: Tissue injury or healing can cause the anal canal to narrow, which makes it difficult to pass gas.

  • Urgency or frequency of stools: Surgery might change bowel habits, leading to urgency or an increased frequency of stools.

  • Faecal or gas incontinence: Despite surgery, incontinence may persist or increase; this is occasionally the result of complications or insufficient treatment of underlying problems. 

An abnormal connection between the vagina and the rectum, also known as the anus, is called a rectovaginal fistula. Gas or faeces may be able to enter the vagina due to bowel contents seeping through the fistula. Rectal fistulas can develop as a result of: 

  • Injury sustained during childbirth

  • Another inflammatory bowel disease is Crohn's disease

  • Cancer or radiation therapy in the pelvic region

  • Pelvic surgery-related complications

  • Complications resulting from diverticulitis, a digestive tract infection affecting tiny, protruding pouches

Stool and gas may seep out of the vagina as a result of the disorder. You might have physical and mental discomfort as a result, which could affect your intimacy and sense of self. 

A rectovaginal fistula may result in the following complications:

  • Uncontrolled excretion of stool

  • Issues with maintaining the perineum's cleanliness

  • Recurring urinary tract or vaginal infections

  • Irritation or inflammation of the skin surrounding your anus, the perineum, or your vagina

  • Recurrence of fistulas

  • Problems with intimacy and self-worth

There is a significant risk of complications for those with Crohn's disease who develop a fistula. These can include the development of a second fistula or a prolonged healing process. 

Surgically treated rectovaginal fistulas may result in the following complications: 

  • Infection: Infection at the surgical site may result in discomfort, oedema, and possibly more dangerous systemic infections.

  • Fistula recurrence: Fistulas can reappear even after surgery, requiring further treatments.

  • Incontinence: Temporary or permanent faecal incontinence may result after surgical manipulation in the vicinity of the anal sphincter.

  • Stenosis: The development of scar tissue can cause the vaginal or anal orifice to narrow.

  • Sexual dysfunction: Vaginal Surgery may affect a person's ability to have and enjoy sexual relations.

  • Healing complications: Inadequate wound healing might lead to fistula persistence or disintegration, which calls for additional care. 

Following rectovaginal fistula and anal incontinence surgery, modifying one's lifestyle can promote healing and reduce problems. These include drinking enough water, not straining when passing gas, and sticking to a high-fibre diet to control and avoid constipation. Frequent exercise also helps to maintain general health and regularity of the bowels. By strengthening the muscles supporting the rectum and vagina, pelvic floor exercises like Kegels can enhance continence. Furthermore, reducing the chance of recurrence and promoting recovery can be achieved by quitting smoking and avoiding heavy lifting. It's essential to follow up with medical professionals regularly to discuss any concerns and track any progress. 

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