Faecal Incontinence Treatment in Melbourne

The cost of treatment depends on the pathway required. Conservative management, investigations, and specialist consultations attract Medicare rebates. Sacral neuromodulator implantation and sphincteroplasty are Medicare-listed procedures when performed for appropriate indications. For surgical treatment, total costs include the surgeon’s fee, anaesthetist’s fee, device costs (for neuromodulation), and hospital facility charges. With private health insurance, out-of-pocket costs vary depending on your fund and policy level. A detailed cost estimate will be provided before any procedure. We recommend contacting your health fund to confirm your cover and any applicable waiting periods.

Faecal incontinence is more prevalent than commonly appreciated. Australian studies estimate it affects approximately 1 in 20 people in the general population, with rates increasing markedly in older adults and in residential aged care settings ^[1]. Many people do not report symptoms to their doctor due to embarrassment, meaning the true prevalence is likely higher. It is a treatable condition, and seeking assessment is an important first step.

Faecal incontinence can result from a range of causes, often occurring in combination. Common causes include injury to the anal sphincter muscles (most often during childbirth), pudendal nerve damage, rectal prolapse, loose or watery stools from conditions such as irritable bowel syndrome or inflammatory bowel disease, reduced rectal capacity following surgery or radiation, and age-related changes in sphincter tone and rectal sensation. A thorough assessment is needed to identify the contributing factors in each patient.

Yes. For many patients, faecal incontinence can be significantly improved through conservative measures, including dietary modification, loperamide, pelvic floor physiotherapy, and biofeedback training. Conservative management is always the first step and is effective in a meaningful proportion of patients. Surgical treatment is reserved for those who have not responded adequately to conservative measures or who have a specific structural problem, such as a sphincter defect, that is amenable to repair.

Sacral nerve stimulation delivers mild electrical impulses to the sacral nerves, which regulate bowel and bladder function and the pelvic floor muscles. The mechanism by which it improves faecal incontinence is not fully understood but is thought to involve modulation of both afferent sensory signals and efferent motor control of the sphincter complex. The procedure involves a reversible trial phase before any permanent implant is placed, allowing patients and the surgeon to assess the response before committing to a permanent device.

Most patients spend one night in the hospital following sphincteroplasty. The perineal wound requires careful hygiene and is typically managed with regular cleaning and absorbable sutures. A soft diet and stool softeners are used during the first 2 weeks to support healing. Full recovery takes approximately 4-6 weeks. Results tend to improve gradually over the first 3-6 months as the repaired sphincter muscle strengthens and pelvic floor rehabilitation progresses.

Pelvic floor physiotherapy is recommended for the majority of patients with faecal incontinence, regardless of whether further treatment is planned. It is an effective standalone intervention for many patients and complements procedural and surgical treatments by maximising pelvic floor muscle function and sensory awareness. We will provide a referral to a specialist physiotherapist as part of your management plan.

The investigations recommended will depend on your specific symptoms and history. Most patients will undergo anorectal manometry to assess sphincter pressures and rectal sensation, and endoanal ultrasound to evaluate sphincter anatomy. Additional investigations, such as proctography or pudendal nerve testing, may be recommended in selected cases. These investigations are performed prior to your treatment planning appointment and guide the selection of the most appropriate management approach.

Spontaneous improvement without treatment is uncommon, particularly where there is an underlying structural cause such as a sphincter defect. However, symptoms may fluctuate with changes in stool consistency, diet, and general health. Many patients find that addressing modifiable factors such as diarrhoea, dietary triggers, and dehydration produces meaningful improvement even before formal treatment begins. Early assessment allows a structured plan to be put in place and prevents unnecessary delay in accessing effective treatment.

You should seek a specialist opinion if faecal incontinence is affecting your quality of life, causing you to limit social activities, or has not improved with simple dietary measures. Even mild symptoms warrant assessment, as early intervention often produces better outcomes. We can provide a thorough evaluation, identify the underlying cause, and recommend the most appropriate management pathway for your situation.