Video Comment on Gourcerol et al.

Guillaume Gourcerol et al. Botulinum toxin: an endoscopic approach for treating fecal incontinence

In a series of 26 patients with fecal incontinence, 17 with a naive rectum and 9 with a neo-reservoir following resection, injecting botulinum toxin A (BTXA) in the rectum/reservoir achieved an improvement in the continence scoring system and in the quality of life score. BTX-A injections were associated with constipation (n = 4) and abdominal pain (n = 2), which disappeared with an adapted treatment. One patient developed an abdominal wall abscess that healed with conservative treatment. As BTX-A has only a transient effect owing to nerve regeneration, a placebo-controlled study with longterm follow-up is needed.