Addressing Fecal Incontinence and Pelvic Organ Prolapse
Advanced Treatments to Improve Quality of Life

To address fecal incontinence and pelvic organ prolapse, sacral nerve stimulation therapy and laparoscopic surgery are utilized to improve quality of life (QOL). Approximately 70% of patients can expect effective results for fecal incontinence.

Providing Medical Institution

Kishiwada Tokushukai Hospital

〒596-0042
4-27-1 Kamoricho, Kishiwada City

https://kishiwada.tokushukai.or.jp/en/

Specialty

**Cardiovascular Surgery:**
1. Coronary Artery Disease
2. Heart Valve Disease
3. Aortic Aneurysm
4. Aortic Dissection
5. Arteriosclerosis Obliterans
6. Arterial Thrombosis
7. Complications of Myocardial Infarction
- Ischemic Cardiomyopathy
- Left Ventricular Rupture
- Left Ventricular Aneurysm
- Ventricular Septal Rupture
- Papillary Muscle Dysfunction (Mitral Regurgitation)
8. Infective Endocarditis
9. Intracardiac Tumors

**Cardiology:**
1. Ischemic Heart Disease (e.g., Angina, Myocardial Infarction)
2. Lower Limb Arteriosclerosis Obliterans
3. Arrhythmia
4. Heart Valve Disease
5. Aortic Stenosis
6. Mitral Regurgitation

**Lower Gastrointestinal Surgery**
*Da Vinci Si - Robot-Assisted Surgery*
1. Malignant Diseases
2. Surgical Treatment of Small and Large Intestine Diseases
3. Primarily Surgical and Medical Treatments for Colon and Rectal Cancer
4. Robot-Assisted Surgery
5. Laparoscopic Surgery
6. Multimodal Therapy Combining Surgery, Chemotherapy, and Radiation Therapy
7. Systemic Chemotherapy for Unresectable Colorectal Cancer

**Breast Surgery:**
1. Breast-Conserving Surgery
2. Mastectomy
3. Sentinel Lymph Node Biopsy
4. Lymph Node Dissection
5. Breast Reconstruction Using Autologous Tissue

**Neurosurgery:**
1. Stroke
2. Cerebral Hemorrhage
3. Subarachnoid Hemorrhage
4. Cerebral Infarction
5. Head Trauma
6. Traumatic Intracranial Hematoma
7. Skull Fracture
8. Chronic Subdural Hematoma
9. Brain and Spinal Cord Tumors
10. Acoustic Neuroma
11. Pituitary Tumor
12. Meningioma
13. Metastatic Brain Tumors
14. Functional Neurological Disorders
15. Facial Spasm
16. Trigeminal Neuralgia
17. Epilepsy
18. Normal Pressure Hydrocephalus

**Urology**
*Da Vinci Si - Robot-Assisted Surgery*
1. Robot-Assisted Laparoscopic Radical Prostatectomy
2. Prostate Cancer
3. Renal Cancer
4. Upper Urinary Tract Cancer
5. Urolithiasis (Urinary Stones)

**Radiology:**
1. Comprehensive Imaging Diagnosis (X-ray, Ultrasound, CT, MRI, Angiography, PET)
2. Liver Tumors
3. Gastrointestinal Hemorrhage
4. Arterial Embolization for Hemoptysis and Traumatic Hemorrhage
5. Transcatheter Venous Embolization for Gastric Varices
6. Intra-Arterial Chemotherapy for Cancer
7. Reservoir Placement
8. CT-Guided Biopsy (Interventional Radiology - IVR)
9. TomoTherapy - Radixact

**Dialysis**
*Travel Hemodialysis* (Available for Individual Travelers Only, Not for Groups)

**Other**
*Second Opinion* (In-person Only, Online Not Available)

Eligibility Criteria/Exclusions for Treatment

Eligibility Criteria 1. Medical Information: - Diagnosis (e.g., fecal incontinence, chronic constipation, rectal prolapse, or other pelvic functional disorders) - Detailed symptoms (e.g., frequency of fecal incontinence, defecation/urination disorders, severity of pelvic organ prolapse) - Examination results from other institutions (e.g., abdominal CT, MRI, endoscopy, anorectal function tests) - Presence of comorbidities (e.g., diabetes, neurological disorders, heart disease) 2. History of Treatment: - Previous treatments or surgeries related to gastrointestinal or pelvic functional disorders (particularly rectal or prostate surgeries) - Current medications (e.g., anticoagulants, laxatives, antispasmodics) - Presence of allergies or adverse drug reactions 3. Age and Physical Fitness: - Assessment of physical fitness and ability to tolerate surgery or anesthesia, particularly for elderly or comorbid patients - Evaluation of suitability for sacral nerve stimulation therapy or laparoscopic surgery 4. Preoperative Testing and Preparation: - Ability to undergo necessary preoperative tests (e.g., blood tests, ECG, anorectal and pelvic function tests) - Capacity to manage lifestyle adjustments before surgery 5. Postoperative Follow-Up and Lifestyle Guidance: - Willingness to participate in regular postoperative follow-ups and rehabilitation - Compliance with postoperative lifestyle guidance, including dietary adjustments and defecation care

Precautions / Contraindications

Precautions and Contraindications

1. Cases Outside the Indications for Treatment:
- Patients with severe neurological disorders (e.g., fecal incontinence caused by spinal cord injury or neurological diseases) may not benefit from sacral nerve stimulation therapy.
- Patients with a high risk of general anesthesia or severe heart disease may face surgical limitations.
- Patients with active infections or skin inflammation may not be eligible for implant surgery.

2. Risks Related to Sacral Nerve Stimulation Therapy:
- Potential risks such as infection, displacement of electrodes or stimulation devices, and device malfunction, and device malfunction during the therapy process.
- Some patients may not experience effective results, making trial stimulation devices essential for pre-assessment.

3. Risks Related to Laparoscopic Surgery:
- Risks include bleeding, infection, and bowel injury during surgery, requiring careful postoperative management.
- There may be temporary constipation or difficulty with defecation following surgery after surgery, necessitating close monitoring.

---

# Important Pre-Treatment Information

1. Preoperative Preparation:
- Patients taking antiplatelet or anticoagulant medications should follow the doctor’s instructions to discontinue or manage them before surgery.
- Necessary preoperative tests (e.g., anorectal function tests, ECG) must be completed to confirm surgical eligibility.

2. Postoperative Care and Follow-Up:
- After sacral nerve stimulation therapy, contact a medical institution immediately if experiencing abnormal pain, signs of infection, or discomfort with the battery.
- Temporary constipation or difficulty in defecation may occur, requiring dietary management and defecation support.

3. Lifestyle and Daily Precautions:
- Pay attention to possible interference from mobile phones or electronic devices when using the stimulation device and follow usage instructions.
- Regular outpatient visits are necessary to ensure the proper functioning and maintenance of the stimulation device.

4. Regular Follow-Up:
- Regular check-ups after stimulation device implantation or laparoscopic surgery are recommended to monitor progress.
- If symptoms recur or health conditions change, consult a physician promptly.

5. Emergency Response:
- If you experience infection, unusual pain, or device malfunction related to the stimulation device, contact a medical institution immediately related to the stimulation device.
- Ensure emergency contact details for medical institutions and attending physicians are readily available.