Effect and Tolerance of Botulinum A Toxin Rectal Injections on Fecal Incontinence

Inclusion criteria

• Patients with at least one episode of active Fecal Incontinence and /or urgency per week;
• Patients with Fecal Incontinence for at least 3 months;
• Patients with Fecal Incontinence refractory to conventional treatment (medical and biofeedback);
• Patients having read the information letter and signed informed consent;
• Patients with medical insurance.

Exclusion criteria

• Patients younger than 18 years old;
• Pregnant or breast-feeding women or women without effective contraception and of age to procreate;
• Exclusive passive Fecal Incontinence;
• Fecal Incontinence secondary to anorectal malformation, post-surgery, anorectal organic disease (cancer, inflammatory bowel disease, post-radiotherapy etc.), constipation, an anal sphincter lesion which could be repaired as a first step, a rectal prolapse (the inclusion in the study is possible if Fecal Incontinence persists after rectopexy, a neurological disease with rapid progress ( stable neurological status is needed for at least 6 months);
• Patients under guardianship.
• Known Hypersensibility to botulinum toxin;
• Neuromuscular junction pathology (myasthenia, Lambert-Eaton syndrome);
• Anesthesia performed less than 1 month previously;
• Association with antibiotics
• Neurological pathology such as polyradiculoneuropathy;
• Dysphagia, pneumopathy secondary to dysphagia;
• Botulinum toxin injections during the 3 months before the beginning of the study;
• Known Hypersensitivity to albumin;
• History of inhalation pneumopathy.
• Rectoscopy impossible (anal stenosis for example);
• Anti-coagulant or anti-platelet drug or hemostasis disorders.