TREATMENT OF DUAL URINARY AND FECAL INCONTINENCE BY IMPLANTATION OF 2AMS-800 ARTIFICIAL SPHINCTERS - CASE-REPORT

We report the case of a 61-year-old woman with urinary and anal incont inence due to neurologic disease. An AMS 800 artificial sphincter was implanted first round the bladder neck Urinary incontinence with recov ery of satisfactory urinary continence. Four months later, another AMS 800 artificial sphincter was implanted round the anal sphincter. Two revisional procedures had to be performed: replacement of the pump for mechanical failure, and replacement of the low-pressure balloon by a high-pressure one. Finally the patient has been almost completely cont inent with only occasional leakage of feces or liquid stools (follow-u p 24 months after activation). Defecography shows total rectal evacuat ion and anorectal manometry records an anal closing pressure of 70 cm H2O. Dual implantation of artificial sphincters is possible for incont inence of neurological origin, provided bladder and rectal compliance are normal.