Artificial bowel sphincters for severe fecal incontinence. Are they a solution?

Fecal incontinence is a debilitating and common problem with a profound effect on a patient's well being medically, socially, and economically. Non-operative management of this condition includes dietary modification, antidiarrheal medications, and biofeedback. Patients with severe incontinence can be divided into 2 categories. The first group includes patients with an identifiable and isolated anatomic sphincter defect who can expect 80% short-term surgical success using overlapping sphincteroplasty. The second group is patients who will not benefit from sphincteroplasty; fortunately, they are not obligated to permanent stomas. Artificial bowel sphincter (ABS) implantation is a well-established surgical technique, offers a chance for continence, restoration, and improved quality of life with significant functional success rate. The surgeon needs to understand how they function. They should be proficient in different procedure types and match these with the patient's need. Post-operative long-term follow-up continues to help surgeons better serve this type of patient population.