便失禁は稀な疾患か? : 当施設における便失禁患者に対する診療の検討  [in Japanese] Is Fecal Incontinence a Rare Disease? : Clinical Outcome of Management of Patients with Fecal Incontinence in Our Institute  [in Japanese]

便失禁は患者にとっては精神的にも社会的にも大きな負担となる．当施設における便失禁患者の診療の現況を明らかにすることを目的として，レトロスペクテイブに検討した．1998年4月より2008年3月までの間に，134人（男性42人，女性92人，平均年齢57.5歳）の初診便失禁患者が受診した．受診契機は他院からの紹介あるいは事前に何らかの情報を得て受診した患者が102人（76.1%）であり，何らの事前情報なしに外来を受診した患者は32人（23.9%）であった．初診時における便失禁の推定原因は，原因が明らかでないもの（特発性）が最も多く68人であった．初診時の臨床的評価でWexner scoreは平均10.3点であった．治療を受けた114人のうち保存的治療のみを受けたものが92人（80.7%），外科的治療を受けたものは22人（19.3%）であった．ポリカルボフィルカルシウムの投与と骨盤体操を行った64人中43人（67.2%）で症状が改善した．また，外科治療を受けた22人中13人（59.1%）の術後機能は良好であった．

Fecal incontinence is a psychological and social burden for patients. We retrospectively reviewed patients with fecal incontinence to clarify the clinical outcome in our institute. Between April 1998 and March 2008, 134 patients with fecal incontinence visited our institute. Forty-two were male and 92 were female, the mean age was 57.5 years. One hundred two patients (76.1%) were referred to or visited our institute after obtaining information through the Internet or newspapers and 32 patients (23.9%) were those who had not obtained any information about fecal incontinence before consultation. The most common presumptive etiology of incontinence was unknown (idiopathic fecal incontinence) and was found in 68 patients. The mean value of Wexner score was 10.3. In 114 patient who received treatment conservative treatment was solely administered in 92 patients (80.7%) while 22 patients(19.3%) received surgical treatment. Forty-three patients (67.2%) out of 64 patients who received conservative management with polycarbophil calcium and pelvic muscle training symptomatically improved. Functional results were good in 13 patients (59.1%) out of 22 patients who received surgical treatment.