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Related Experiment Video

Updated: Apr 30, 2026

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Internal anal sphincter augmentation and substitution.

Fernando de la Portilla1

  • 1Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain.

Gastroenterology Report
|April 25, 2014
PubMed
Summary

Internal anal sphincter (IAS) dysfunction causes passive faecal incontinence. Bulking agents offer a new treatment option, but more research is needed to determine the best methods and materials for effective outcomes.

Keywords:
bulking agentsfaecal incontinenceinternal anal sphincter augmentationinternal anal sphincter dysfunction

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Urology

Background:

  • Internal anal sphincter (IAS) dysfunction is increasingly recognized as a cause of passive faecal incontinence.
  • This condition can arise after anal sphincterotomy, hemorrhoid surgery, or with aging.
  • Current treatments like IAS plication have shown poor results, prompting exploration of alternative therapies.

Purpose of the Study:

  • To review the mechanisms, materials, deployment techniques, complications, and outcomes of bulking agents for IAS dysfunction.
  • To highlight the current knowledge gaps and the need for further research in this area.

Main Methods:

  • Literature review of existing studies on bulking agents for IAS dysfunction.
  • Analysis of purported mechanisms of action, materials used, and surgical techniques.
  • Evaluation of reported complications and patient outcomes.

Main Results:

  • Bulking agents, adapted from urological applications, are being developed for IAS dysfunction.
  • Various materials are in clinical use, with specific deployment methods and reported outcomes.
  • Complications associated with these agents have been documented.

Conclusions:

  • Bulking agents represent a promising approach for managing faecal incontinence due to IAS dysfunction.
  • Significant unknowns remain regarding the optimal agent, volume, and deployment technique.
  • High-quality, prospective, randomized controlled trials are essential to establish definitive treatment guidelines.
  • The potential of autologous stem cells for sphincter regeneration warrants future investigation.