PERIANAL INJECTION OF AUTOLOGOUS FAT FOR TREATMENT OF SPHINCTERIC INCONTINENCE

PURPOSE: The aim of this study was to evaluate the results of treatmen t of partial fecal incontinence with perianal injection of autologous fat. METHODS: The study comprised 14 patients with partial fecal incon tinence (9 women and 5 men). Ages ranged from 38 to 62 years. Fifty to 60 mi of fat were harvested from the abdominal wall and injected subm ucosally into the rectal neck at 3 and 9 o'clock positions. Mean follo w-up was 18.6 months. RESULTS: Ail patients were continent during the first two to three postinjection months. At the sixth month, patients were divided into three scores. Score 1 (complete continence) comprise d three patients who are now continent for 9, 11, and 14 months postin jection, with normalization of their rectal neck pressure. Seven patie nts with Score 2 were incontinent to flatus and were reinjected; they are now continent (Score I) for a mean of 13.8 months and have normal rectal neck pressure. Four patients had Score 3 (no improvement), of w hom two became continent after the second injection and two after the third. They are now continent (Score 1) 6 to 16 months postinjection. Factors that contributed to failure comprised injection of unwashed fa t or wrong positioning of the needle. There was no fat migration or em bolism. CONCLUSION: Perianal fat injection is effective in treatment o f partial fecal incontinence. The technique is simple, easy, cost-effe ctive, and performed on an outpatient basis.