Fecal Incontinence Solutions Reno

Less Invasive Solutions for Loss of Bowel Control

Dr. Sasse provides state of the art solutions for fecal incontinence.

Fecal incontinence has long been a very frustrating and challenging problem, but new, less invasive solutions exist today that make a real difference and make life better.

What is fecal incontinence or bowel incontinence, and why does it occur?

Fecal incontinence is the loss of control of the bowels, resulting in leakage, seepage, frank accidents, and the wearing of pads or diapers. Fecal incontinence can refer to the lack of control of solid stool, liquid stool, or gas.

Bowel incontinence occurs for a number of reasons. While the most common causes stem from pregnancy and childbirth, there are many other causes which can occur in men, or be unrelated to pregnancy.

To begin, fecal incontinence can occur because of disruption of the anal sphincters. This occurs most commonly as a result of childbirth trauma. Additionally, conditions which impair the nerves controlling the center muscles can lead to incontinence. These can be neurologic disorders of many kinds, or can be traction injuries to the nerves that occur during pregnancy. In addition to these causes, there are many other causes including inflammatory conditions, problems with compliance, masses or lesions, and combination causes which lead to impaired control of the bowels.

In order for us to maintain normal continents or bowel control, several factors have to be working successfully. These include normal stool consistency (not being to liquid), normal transit time through the G.I. tract, normal compliance of the rectum, normal muscular function of the sphincters, and normal nerve function both for sensation, and also for strength of contraction of the sphincter muscles.

Who is a candidate for the newer treatments of fecal incontinence?

Individuals are good candidates for the newest treatments of fecal incontinence if they have struggled with leakage, seepage, accidents, or loss of bowel control. If an individual has tried adjusting their diet and has attempted simple strengthening exercises of the sphincters, then the next step is often to try anti-motility medication such as Lomotil. These are considered conservative measures, and if those have not been successful in resolving the problem, then further intervention is warranted with one or more of the treatments discussed in the next section.

 
What are the newest treatments for fecal incontinence, and are they successful?

Many years ago very few effective solutions for loss of bowel control existed. The person suffering with this problem had little choice but to continue living with it or to consider the drastic step of a colostomy.

Nowadays, a range of very effective solutions exists. We begin with an assessment of the muscles and nerves and then a discussion of the range of treatment options to improve the condition.

The newest and best treatments are:

1. Sacral nerve modulation – “The anorectal pacemaker.” Axonics and Medtronic devices are the next generation in sacral nerve modulation therapy. Once you and Dr. Sasse agree on sacral nerve modulation as a treatment option, you will undergo a “trial” of the technology. This trial involves accessing the nerves that play a role in bowel control. The sacral nerves are easily accessed by numbing the skin over the tailbone region and inserting very fine hair-like leads through the bony openings called the sacral foramen. In most cases, a test device will be placed during a 15-20 minute procedure using x-ray guidance and computer testing of the nerves and pelvic floor muscles. A temporary external stimulator will be used to determine whether the bowel control has improved during a week of the trial run. If successful, a permanent implant is inserted in the operating room using fluoroscopy (x-ray) precision guidance. Dr. Sasse will place the leads to the precise location where they will achieve the maximum improvement in the bowel sphincter control. The procedure takes about 30 minutes and is done under local anesthesia, often with some mild sedation.
2. Solesta injection. Solesta is a bulking agent which is painlessly injected into the rectal wall through a small lighted proctoscope in the office, during a 10 minute procedure. The bulking agent is directed precisely in the four quadrants of the rectal submucosa, just at the level of the sphincter muscles. It has a high success rate, with the majority of individuals reporting that they are more than 50% improved after a single treatment. Studies show that the improvement persists two and even three years following the initial injection. It is a 10 minute office procedure that requires no sedation and no anesthesia. It became available in early 2014, and has become widely utilized throughout United States. Dr. Sasse has had many patients who have been successful with Solesta, and many others who have found success with Solesta in combination with other treatments.
3. Both of the above-mentioned treatments are considered highly successful and minimally invasive. Dr. Sasse has a great deal of experience treating fecal incontinence that goes back to 2000 and 2001 during which time he performed laboratory investigations into the field of fecal incontinence and manometric sphincter measurements. In addition to the above treatments, a successful office therapy involves specialized strength training of the pelvic floor muscles through specific positional strength training with neuromuscular monitoring. During this series of treatments with a highly trained specialized therapist in Dr. Sasse’s office, individuals learn to augment the contraction of the most important pelvic floor and sphincter muscles to further enhance the bowel control. These exercises provide improvements in overall pelvic floor strength and improve urinary continence as well.

The treatments outlined above represent a comprehensive solution to the problem of bowel incontinence with a high success rate. In many cases a single treatment will be all that is necessary, but in some cases the treatments will be combined to achieve successful restoration of bowel control, improved confidence, and a restored quality-of-life.

Are these treatments covered by insurance?

YES, all of the treatments outlined above are generally covered by most health insurance plans, including Medicare and the vast majority of commercial insurance plans. Part of the office consultation with Dr. Sasse involves an assessment of the insurance benefit coverage and pre-authorization which is performed as a service by Dr. Sasse’s office staff.

How do I start?

The best way to begin is to call (775) 248-7894 for a consultation. An initial office consultation will be arranged and any simple records or testing can be organized, usually before or on the day of the consultation. If you are a candidate for treatment, then normally a plan to restore bowel control can be started right away.

Why Choose Dr. Sasse and The Continence Center?

Dr. Sasse…

• Completed his Fellowship training in Colon and Rectal Surgery at the Lahey Clinic in Boston, Massachusetts.
• Conducted research and performed numerous pelvic floor evaluations for incontinence at the Lahey Clinic pelvic floor lab.
• Received a research award for his work on leakage and incontinence.
• Founded the first Continence Center in northern Nevada, offering complete evaluations with pelvic floor manometry and ultrasound.
• Has been providing outstanding relief to hundreds of patients using sacral neuromodulation.
• Serves as an adjunct assistant professor of surgery and cell biology at the School of Medicine of the University of Nevada.
• Has decades of experience with bowel and bladder disorders related to many conditions including diabetes, radiation, childbirth, aging, obesity, nerve injury, and trauma.