In our institution, sphincteroplasty has been widely used for cases of fecal incontinence that have not been sufficiently improved by conservative treatment, including in men. Regarding the long-term results of sphincteroplasty, a high recurrence rate of fecal incontinence has been reported. In addition, sacral neuromodulation therapy (SNM) has been covered by social insurance, and the Japanese fecal incontinence treatment guidelines state that both SNM and sphincteroplasty are applicable for fecal incontinence accompanied by sphincter injury. As a result, the number of sphincteroplasty cases at our hospital has dropped dramatically since 2015.

In this study, we focused on 11 cases of sphincteroplasty performed between June 2015 and May 2024 after the introduction of SNM. Nine were women, with an average age of 56 year old.

Resting pressure changed from 48.6 to 46.5 before and after surgery. Squeezing pressure increased from 158 to 207, but no significant difference was observed. Cleveland Clinic Florida Fecal Incontinence Score (CCFFIS) improved significantly from 11.8 to 7.4 (p<0.001).

Although the number of sphincteroplasty cases has decreased with the introduction of SNM, this study reaffirmed that sphincteroplasty improves fecal incontinence symptoms and is considered to be a treatment option that should be offered to patients in cases where SNM is not appropriate or who are uncomfortable with having a foreign object implanted in their body.