As part of the #ESCPFIMonth campaign, Gabriele Naldini joins Leandro Siragusa to explore key aspects of faecal incontinence management - from sphincteroplasty techniques and overlapping vs end-to-end repairs, to decision-making in complex pelvic floor cases.
Drawing on real clinical scenarios and surgical footage, the conversation highlights the need for personalised treatment approaches, particularly in patients with severe or recurrent damage. The pair also touch on the importance of balancing anatomical repair with functional outcomes, especially in younger women, where overtightening may affect quality of life.
Key themes include:
- Selecting the right surgical approach for different types of sphincter damage
- Technical details on achieving reliable overlapping repairs
- The role of muscle continuity in choosing when to use sacral neuromodulation
- Limitations in current guidelines and the case for stronger definitions and tools
This interview provides a valuable practical perspective for colorectal surgeons, reinforcing that individualised care, experience-based judgement, and honest discussion with patients are central to improving outcomes.