If you need surgery

If you need surgery

If your doctor thinks surgery might help you, he or she should refer you to a specialist surgeon. The surgeon should discuss the possible options with you, explaining the risks and benefits and how likely the operation is to work.

The type of operation offered will depend on what is causing your incontinence. For example, if you have a defect in your anal sphincter you may be offered an operation to repair it. If this is not suitable for you, the following surgical procedures may be considered. If you decide to have one of them you should be offered ongoing support to help you.

  • Stimulated graciloplasty involves making a new anal sphincter from muscle taken from the thigh. Electrical stimulation is applied to this new sphincter to strengthen it. For more information see http://guidance.nice.org.uk/IPG159/publicinfo

  • Artificial anal sphincter implantation involves placing a circular cuff under the skin around the anus, to allow you to control when you open your bowel. For more information see http://guidance.nice.org.uk/IPG66/PublicInfo

  • Sacral nerve stimulation is a way of using electrical pulses to keep the anal sphincter closed. It involves inserting electrodes under the skin in the lower back. For more information see http://guidance.nice.org.uk/IPG99/publicinfo

  • Antegrade irrigation involves washing out the colon with water, using a tube going through the wall of the abdomen into the appendix.

If there are no suitable treatments, your doctor may consider offering you a stoma if you have incontinence that severely affects your everyday life. A stoma is an opening from your bowel through your abdomen, created by a surgeon. If this is the case, you will first be seen by a specialist stoma care service and your doctor will explain all the risks, benefits and long-term effects to you.

Questions about surgery

  • Is there an operation that might help my condition?

  • What are the risks and benefits of the operation?

  • Are the risks minor or serious? How likely are they to happen?

  • How likely is it to work in the long term?

  • Can the operation be reversed?

  • Can you tell me about other surgical procedures that might help?

  • Has NICE published any guidance on these procedures?

  • What are the alternative treatment options?