We thank you for your interest in our hospital. Our Department of General and Colorectal Surgery especially deals with the conservative and surgical treatment of fecal incontinence.
During my time at the University of Freiburg, Germany, I was lucky to serve for many years as a consultant for the gynaecological department. Performing operations together with my gynaecological collegues enlarged my knowledge especially with respect to the pelvic floor; I learned to see the pelvic floor with uro-gynecological eyes. It was that time when I realized that cystocele, genital descend/prolaps, rectal prolaps/rectocele or fecal incontinence are mostly not unrelated diseases but rather connected with one another, that is, a problem not only of one compartment but rather that of two or even all three compartments of the pelvic floor. As a consequence, in my view, pathologies of the pelvic floor should be repaired during one operation and not each organ by a different doctor at different times by different specialities (proctologist, gynaecologist or urologist). Since in my former hospital a gynaecological department was lacking I started to attend many workshops to learn transanal, transperineal, transvaginal and transabdominal procedures. Finally, I started to not only rewind a rectal prolaps/rectocele but also at the same time to remove a genital prolapse or cystocele – with great success and satisfaction for the patients. In the present hospital I am lucky to have a very competent gynaecological department at my side allowing to operate complex cases together.
When a patient presents with fecal incontinence we always look at all three compartments of the pelvic floor. Causes for fecal incontinence can be very different. Sometimes, a correction of a hemorrhoidal prolapse or a reconstruction of a damaged anal sphincter is sufficient to restore continence. In other cases continence is achieved by removing an internal prolapse or rectocele; in very severe cases complete remodelling of the pelvic floor is necessary.
Unfortunately, in some cases restoring the anatomy is not sufficient to achieve fecal continence. In those cases the disintegration of the pelvic floor is irreversible and further steps are required to obtain continence. In our hands the next step is the Sacral Nerve Stimulation (SNS) with a success rate of 60 – 70 %. If SNS fails then we offer as the ultimate procedure for fecal incontinence the implantation of an artificial anal sphincter with a success rate of more than 90%.
Because of our large experience with the artificial anal sphincter surgeons from all over the world are trained for this operation in our hospital.
If you suffer from fecal or urinary incontinence feel free to contact us. Do not allow yourself to be excluded from social life because of the disease. In many cases the quality of life after appropriate treatment of the incontinence can be changed dramatically which enables the patients to live a normal and satified life. So, do not hesitate - step on it.
Prof. Dr. Ulrich Baumgartner
Chief of the Dept of General and Colorectal Surgery