Artificial bowel sphincter (ABS) for severe faecal incontinence: a clinical and manometric study

As experience with artificial sphincters for severe faecal incontinence is still limited, the authors' aim was to report on the outcome following implantation of the ABS in their series.

Eight women (mean age 56 years, range 48-64 years) with severe faecal incontinence refractory to conservative treatment underwent ABS implantation. This condition was idiopathic in six of the patients, due to trauma in one and due to malformation in the remaining one. The mean preoperative score for incontinence (AMS classification) was 96.2 (range 70-108). Two of the patients had rectal prolapse and three anterior colpocele.

Two patients had post-operative infection requiring implant removal. In the six other patients (mean follow up 10.5 months, range 4-23 months) the mean incontinence score was 19.4 (range 0-61). Continence to solid stools was achieved in all six patients, although one complained of occasional episodes of incontinence to liquid stools and another of episodes of soiling; none had intolerance to the device, which functioned satisfactorily.

Our findings indicate that the ABS implant is well tolerated and may be a valid option in the treatment of severe incontinence, even in the presence of complex pelvic disorders, although the risk of infection must always be borne in mind. Studies on larger series with longer follow ups are required to confirm these preliminary findings.