Skeletal Muscle-Derived Cell Implantation for the Treatment of Fecal Incontinence: A Randomized, Placebo-Controlled Study.

Background And Aims: Fecal incontinence (FI) improvement following injection of autologous skeletal muscle-derived cells has been previously suggested. This study aimed to test the efficacy and safety of said cells through a multicenter, placebo-controlled study, to determine an appropriate cell dose, and to delineate the target patient population that can most benefit from cell therapy.

Methods: Patients experiencing FI for at least 6 months were randomized to receive a cell-free medium or low or high dose of cells.

Sacral neuromodulation for faecal incontinence - 10 years experience and long-term outcomes of a specialized centre.

Introduction: Sacral neuromodulation/sacral nerve stimulation (SNM/SNS) has become the most successful method for treatment of faecal incontinence (FI) in the last 10 years. The high efficiency of SNM is based on the electrical stimulation of the external anal sphincter and moreover the mechanism of action of SNS can be explained by the modulation of somatovisceral reflexes and perceptions of afferent information. Therefore the mechanism of action is more complex in contrast to other methods of treatment.

[Anorectal injury].

Anal and rectal traumas are relatively rare (with the exception of iatrogenic damage) due to the anatomical position of the anorectum. The anal canal is injured more frequently due to its relatively superficial position, but injuries involving the extraperitoneal rectum, although more rare, tend to be much more severe and may affect the surrounding organs. Intraperitoneal rectal injury is associated with bleeding or perforation and may lead to peritonitis and diffuse contamination of the abdominal cavity.

[Acute periproctal abscesses].

Periproctal inflammations related to the anus are characterized by the rapid spread of the infection to the surrounding tissue, which is determined by the anatomical characteristics and infectious agents. Inflammation, which starts as a phlegmon, quickly forms boundaries and an abscess develops in most cases. Up to 80-90% of anorectal abscesses develop according to the crypto-glandular theory on the basis of infection of the anal glands, spilling into the Morgagni crypts in the anal canal.

[Complications of hemorrhoids].

The most common and serious complications of haemorrhoids include perianal thrombosis and incarcerated prolapsed internal haemorrhoids with subsequent thrombosis. They are characterised by severe pain in the perianal region possibly with bleeding. In a short history of the perianal thrombosis, acute surgical incision or excision is indicated, which can result in rapid relief of the painful symptoms.