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The artificial bowel sphincter for faecal incontinence: a single centre study
Jarno Melenhorst1, Sacha M Koch, Wim G van Gemert
1Department of Surgery, University Hospital Maastricht, P. Debyelaan 25, Postbus 5800, 6202 AZ, Maastricht, The Netherlands.
International Journal of Colorectal Disease
|October 12, 2007
Summary
The artificial bowel sphincter (ABS) effectively treats fecal incontinence in patients with large anal sphincter defects. However, infection remains a significant risk, potentially requiring device removal.
Area of Science:
- Colorectal Surgery
- Medical Device Technology
Background:
- Faecal incontinence (FI) significantly impacts quality of life.
- Treatment options for FI include sphincter replacement procedures for large anal sphincter defects.
- Dynamic graciloplasty and artificial bowel sphincter (ABS) are surgical options.
Purpose of the Study:
- To evaluate the efficacy and safety of the artificial bowel sphincter (ABS) for treating faecal incontinence (FI).
- To assess the impact of ABS implantation on patient's incontinence scores and anal manometry.
- To identify complications associated with ABS implantation.
Main Methods:
- A cohort of 34 patients with faecal incontinence due to large anal sphincter defects were included (1997-2006).
- All patients underwent a comprehensive preoperative evaluation.
- Follow-up included the Williams incontinence score and anal manometry.
Main Results:
- The artificial bowel sphincter (ABS) significantly improved the Williams incontinence score (p<0.0001).
- Postoperative ABS pressure was significantly higher than baseline squeeze pressure (p=0.003).
- Seven patients (20.6%) experienced infections requiring device explantation; one patient was successfully reimplanted.
Conclusions:
- The artificial bowel sphincter (ABS) is an effective treatment for faecal incontinence in patients with large anal sphincter defects.
- Infectious complications represent the primary threat, often necessitating explantation of the device.
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