Anal incontinence may need to be corrected by the creation of a neoanal sphincter by providing innervated muscle tissue from a nearby muscle. Any such procedure would need the application of the basic principles of plastic surgery. So anal incontinence cases also do get referred to the plastic surgeon. Minor incontinence is the inadvertent escape of flatus or the soiling of undergarments which can usually be tackled by attention to local causative conditions.
Major incontinence is the involuntary excretion of stools of normal consistency.
This includes the usual history, examination and investigation. Today there is a gamut of investigative procedures8 available. Some help in making a complete diagnosis and in deciding on the therapeutic regimen. Some investigative procedures help in making an objective documentation of a case before and after therapy, in order to prove the efficacy of the chosen therapeutic regimen. The surgical procedure suitable for a particular case can only be decided upon after a total understanding of the underlying pathophysiologic abnormality in that case.