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Incontinence rates after cutting seton treatment for anal fistula
Author(s) -
Ritchie R. D.,
Sackier J. M.,
Hodde J. P.
Publication year - 2009
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2008.01713.x
Subject(s) - medicine , anal fistula , fistula , anal sphincter , surgery , sphincter , incidence (geometry) , general surgery , physics , optics
Objective To determine the incidence of anal incontinence after the use of cutting seton treatment for anal fistula. Method Literature searches were performed on PubMed, MEDLINE and Google ™ Scholar using the words ‘cutting seton(s)’, ‘seton(s)’ and ‘anal fistula’. An analysis of the data in the collected references was performed. Results The average rate of incontinence following cutting seton use was 12%. The rate of incontinence increased as the location of the internal opening of the fistula moved more proximally. In the studies that described the types of incontinence, liquid stool was the most common followed closely by flatus incontinence. Incontinence associated with the treatment of fistulas defined as nonspecific cryptoglandular in nature was 18%. Conclusion The high incontinence rates that result from the use of cutting setons suggest that this commonly used therapy can damage the continence musculature. Other techniques that do not involve cutting the sphincter, when available, should be preferred, especially for higher fistulas.