Artificial anal sphincter

W. Douglas Wong, Linda L. Jensen, David C C Bartolo, David A. Rothenberger

Research output: Contribution to journalArticlepeer-review

142 Scopus citations

Abstract

PURPOSE: This study was undertaken to evaluate the use of a fully implanted artificial anal sphincter for management of severe fetal incontinence. METHODS: An artificial anal sphincter was implanted in 12 patients who failed conventional management for severe fecal incontinence. Careful patient follow-up was recorded during a mean 58-month follow-up. Patients underwent preoperative and postoperative manometric assessment. Functional and patient satisfaction evaluations were obtained by mailed questionnaire. RESULTS: Three infections and three mechanical complications occurred in four patients (33 percent). A successful outcome was achieved in nine patients (75 percent). Postoperative manometric studies documented establishment of an elevated high-pressure zone compared with preoperative resting pressures. Seven patients returned a detailed functional assessment and patient satisfaction questionnaire at a mean of 40 months postsphincter activation. All seven patients reported continence to solid stool. Two patients had some problems with control of liquid stool, and three had occasional incontinence to flatus. Six of the seven patients rated their bowel control as good to excellent. All seven respondents were satisfied with their functional improvement. CONCLUSIONS: Early experience with an artificial anal sphincter has demonstrated that continence can be restored with acceptable morbidity in patients with severe fecal incontinence.

Original languageEnglish (US)
Pages (from-to)1345-1351
Number of pages7
JournalDiseases of the colon and rectum
Volume39
Issue number12
DOIs
StatePublished - 1996

Keywords

  • Anal incontinence
  • Artificial anal sphincter
  • Fecal incontinence
  • Surgical technique

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