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Quality of life aspects determining the‑bio‑psycho‑social functioning of patients in the‑perspective of a planned extensive sphincter’s repair procedur

100%

Żelazny D., Romaniszyn M., Wałęga P.

Damage to the sphincter, regardless of its pathogenesis, consists in the impossibility to control the physiology, or the so-called faecal incontinence. This implies changes in the whole bio-psycho-social functioning of the patients, and thus affects the satisfaction with their quality of life, conditioned by their health status. The problem affects around 5 to 7% of the population. Often enough, the only hope for those patients are repair procedures of the sphincter mechanism. The aim of the study was to evaluate key aspects of quality of life which determine the psycho-social status of patients with endogenous or iatrogenic sphincter damage in the perspective of a planned extensive sphincter’s repair procedure. Material and methods. The study group consisted of 52 people, 26 women and 26 men, aged 19–72. The scale by Rockwood – Fecal Incontinency Quality of Life – was used as the basic research tool which evaluates the quality of life in four aspects: 1/behavioral (Lifestyle) 2/cognitive (Coping) 3/emotional (Depression) 4/overall self-assessment (Embarrasment). The degree of incontinence was determined based on point scales of Jorge Wexner (JW scale) and the Fecal Incontinenece Severity Index (FISI scale). Structured diagnostic interview was also used in the study. Results. The results show that lack of control over the basic physiological functions disintegrates the quality of life in all evaluated aspects related to somatic, psychological and social functioning. FIQL: Lifestyle (LS) – 1.96 pts Coping (C) – 1.67 pts Depression (D) – 2.1 pts Embarrasment (E) – 1.79 pts Conclusions. The FIQL results presented explain the fact that among 52 patients followed, 50 decided to conduct extensive reconstructive procedures, although the results are not statistically optimistic and the risk of complications is relatively high

Anterior overlapping sphincteroplasty – who benefits from the surgery?

88%

Mik M., Rośniak K., Narbutt P., Dziki Ł., Tchórzewski M., Trzciński R., Dziki A.

Polish Journal of Surgery

2015

vol. 86

issue 1

33-38

The aim of the study was to identify clinical factors which could influence the results of overlapping sphincteroplasty. Material and methods. Between 2003-2009 the group of 78 incontinent patients (59 women, mean age of 61±13 years), was operated on with anterior overlapping anal sphincteroplasty. Only patients with severe incontinence (>16 pts in Wexner scale) were included. Before surgery and in follow-up period anorectal ultrasound, manometry and incontinence assessment were performed and in follow-up period patients additionally fulfilled survey. The study was prospective. Follow up period was more than 36 months. Results. In survey the excellent results related to 52 patients (66.7%), good in 15 (19.2%) and poor in 11 (14.1%). The squeeze pressure improved more significantly in men 33±11 cm H2O vs. 22±14 cm H2O; p=0.039. In patients <50 year squeeze pressure was significantly larger 32±10 cm H2O vs. 25±12 cm H2O; p=0.045. If the width of a defect within sphincter was less than 60°飀 the improvement in squeeze pressure was higher 33±9 cm H2O vs. 22±15 cm H2O; p=0.031. In Wexner scale male patients better responded to surgery than females 6.94±1.8 vs. 5.12±2.2, p=0.048; as well as patients with smaller scar <60° 6.51±1.4 vs. 4.28±2.3; p=0.042. Conclusions. To succeed in sphincteroplasty the proper qualification to the procedure should be crucial. Clinical assessment prior to surgery with the use of all available non-surgical methods in patients suffer from severe symptoms can help to select optimal group who will benefit from surgery. Male patients may have to obtain better outcome and patients with smaller sphincter defect could likely have also better results from surgery.

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2 Polish Journal of Surgery

1 2015

1 2014

1 Dziki A.

1 Dziki Ł.

1 Mik M.

1 Narbutt P.

1 Romaniszyn M.

1 Rośniak K.

1 Tchórzewski M.

1 Trzciński R.

1 Wałęga P.

1 Żelazny D.

Search results

Quality of life aspects determining the‑bio‑psycho‑social functioning of patients in the‑perspective of a planned extensive sphincter’s repair procedur

Anterior overlapping sphincteroplasty – who benefits from the surgery?