Over the past three decades care of patients with pelvic floor disorders has changed
dramatically. Fecal incontinence surgery that initially was repair or encircling the
anal sphincter now is treated as a first line with sacral nerve stimulation. Rectal
prolapse surgery has benefited from minimally invasive approaches and an abdominal
approach is considered even in older frail individuals. Medication for constipation
has dramatically helped more patients avoid surgery. A multidisciplinary approach
with surgeons operating during the same anesthesia on the middle/anterior pelvis and
posterior pelvis is common. Evaluation of outcomes and patient-reported outcomes are
the norm. We have come a long way toward care of this group of patients, but we still
have huge steps to achieve to optimize care as we look toward the next 30 years.
Keywords
fecal incontinence - rectal prolapse - slow-transit constipation - outlet constipation
- rectovaginal fistula
