Abstract
Purpose Dynamic graciloplasty (DGP) has been used to treat severe fecal incontinence since
the 1980s. Previous studies have shown an inferior outcome in patients with anorectal
malformations (ARMs). Our experience has been that DGP has been appreciated by ARM
-patients. The objective of the study was to evaluate the long-term outcome of DGP
in our patients with ARM compared with patients with other underlying conditions.
Materials and Methods Twenty-three patients operated with DGP at our institution from 1996 to 2010 were
sent validated bowel function and quality of life questionnaires. Eighteen of 23 responded.
Seven had ARM and 11 had other etiologies of fecal incontinence. The mean follow-up
time was 11.6 years (range, 5–17).
Results Four of 7 of the patients with ARM and 8 of 11 of patients with other etiologies
used their implants at follow-up. The Miller incontinence score was slightly higher
for patients with ARMs, but they had less constipation and higher Fecal Incontinence
Quality of Life (FIQL)- and 36-Item Short Form Health Survey (SF-36) scores. None
of the differences were statistically significant.
Conclusion This study cannot confirm earlier reports in which DGP has an inferior outcome in
patients with ARM. We therefore believe that the procedure should remain a treatment
option for selected patients.
Keywords
anorectal malformation - fecal incontinence - dynamic graciloplasty - long-term outcome
