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Artificial bowel sphincter implantation for faecal incontinence in Asian patients
Kaweesak Chittawatanarat1, Dean C Koh, Aileen A Seah
1Division of Colorectal Surgery, Department of Surgery, National University Hospital Singapore, 5 Lower Kent Ridge Road, Singapore.
Background:
To evaluate the outcomes with the American Medical Systems artificial bowel sphincter (ABS) implantation for the treatment of intractable faecal incontinence in an Asian population.
Methods:
Six Asian patients who underwent ABS implantation between March 2004 and December 2007 for the treatment of faecal incontinence were reviewed.
Results:
The ABS was successfully implanted in six patients [mean age 50 (20-73) years; 4 males]. The most common causes of incontinence were congenital anomaly of the anus (imperforate anus status post a pull-through procedure) and status-post ultralow anterior resection. Two patients required device explantation due to postoperative infection. One eventually required a colostomy. After a mean follow-up of 22 (4-36) months, four patients continued to have a functional artificial bowel sphincter. Faecal incontinence severity scores improved from a mean of 13 (12-14) to 6 (0-9) postactivation. Anal manometry showed an increase in mean resting pressures (19.2 +/- 7.5 mmHg vs. postimplantation with cuff inflated 45.0 +/- 12.0 mmHg). The comparative preoperative and postactivation faecal incontinence quality of life scores showed improvement in all aspects.
Conclusions:
Patients with successful ABS implantation benefited from improved outcomes in function and quality of life. Infection was the most common cause of failure in our patients.
