DEFECOGRAPHIC EVALUATION OF DYNAMIC GRACILOPLASTY FOR FECAL INCONTINENCE

PURPOSE: A prospective defecographic study was per formed to evaluate the anorectal physiology of dynamic graciloplasty (gracilis muscle tra nsposition and subsequent implantation of an electric stimulates) for treatment of fecal incontinence. METHODS: From November 1986 until May 1993, 38 consecutive patients with incapacitating fecal incontinence were treated with ''anal dynamic graciloplasty.'' Defecography was per formed before and after surgical procedures. Defecographic data (anore ctal angle, perineal descent, anal canal length, anal canal width, and anal leakage) were correlated with respect to clinical outcome and an al manometry. RESULTS: Fecal continence was achieved in 24 patients, w hich correlated significantly with no leakage of barium contrast durin g defecography (P < 0.01, Kruskal-Wallis one-way analysis of variance) . In addition, minimum anal canal width decreased from 7 mm before sur gery to 1 mm after dynamic graciloplasty (P < 0.01, paired Student's t -test). CONCLUSION: Defecography is an efficient method to evaluate dy namic graciloplasty for fecal incontinence.