INCONTINENCE AFTER ILEOANAL POUCH ANASTOM OSIS - DIAGNOSTIC-CRITERIA AND THERAPEUTIC CONSEQUENCES

After ileo-pouch-anal anastomosis (IPAA) there is an increased risk of incontinence due to intraoperative damage of the anal sphincter. We p resent a new concept to identify a potential incontinence prior to the closure of ileostomy by clinical and anal manometrical examinations. In 11 of 121 (9.1%) patients we diagnosed a potential incontinence. By biofeedback training we could achieve in this way a sufficient contin ence after the closure of ileostomy. After an average of 5.0 +/- 4.3 m onths of training rest pressures improved from 19.3 +/- 2.1 mmHg to 33 .0 +/- 3.5 mmHg and squeeze pressures from 60.5 +/- 27.7 mmHg to 93.5 +/- 17.3 mmHg. Prior to IPAA patients with potential incontinence show significantly reduced rest pressures of 51.0 +/- 18.4 mmHg.