Relapsing faecal incontinence in the elderly: a no man’s land

Background Post-obstetric neuropathic faecal incontinence is a complex disorder of impaired motor function involving the sphincters and pelvic floor, often associated with impaired rectal evacuation and anorectal anaesthesia [1]. Direct trauma to the anal sphincter complex can give immediate problems or problems later in life. The initial therapy should be conservative. Patients with anatomic sphincter defect or with extensive sphincter damage, muscle loss or pudendal neuropathy are very likely to need surgery. Several surgical approaches have been proposed, but results still remain disappointing, although quality of life seems to be improved [2]; after the initial enthusiasm, the role of artificial bowel sphincter (ABS) has been scaled-down. These problems are even harder to face in elderly patients previously operated on with poor outcome for faecal incontinence.