OUTCOME OF PATIENTS WITH AN IMPLANTED ARTIFICIAL ANAL-SPHINCTER FOR SEVERE FECAL INCONTINENCE - A SINGLE INSTITUTION REPORT

Implantation of an artificial sphincter is an alternative treatment fo r patients with severe faecal incontinence. This prospective study fro m one institution has evaluated the results from 13. Preoperative and postoperative incontinence scores, anal manometry, and quality of life were evaluated in 13 patients who had undergone implantation of an ar tificial sphincter over a 7-year period. Two patients were definitive failures. One developed acute total colitis after 5 years of satisfact ory function, and a second had discomfort and demanded removal of an o therwise functioning device. After a median follow-up of 30 (range 5-7 6) months. II patients had an activated and functional device. These i ncluded 6 with a urinary AMS 800 and 5 with the newly designed anal AB S. The mean incontinence score decreased from 17 to 4, and quality of life improved markedly. Two Of the 11 patients had undergone successfu l reimplantation, one following rupture of the cuff and the second fol lowing ulceration of the control pump through the labia, In no case wa s infection or erosion of the anal canal a cause of failure. While the cause of incontinence and age did not affect outcome, psychological r eaction had a significant impact. The artificial anal sphincter may ha ve a role to play in severe faecal incontinence.