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The Gatekeeper™ for fecal incontinence: Another trial and error
Labib Al-Ozaibi1, Yasmin Kazim1, Wessam Hazim1
1Rashid Hospital, Dubai, United Arab Emirates.
International Journal of Surgery Case Reports
|December 3, 2014
Summary
The Gatekeeper™ bulking agent, used for fecal incontinence, may cause prosthesis migration and perianal abscess, similar to other agents. Further research is needed to evaluate its safety and efficacy compared to alternatives.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- The Gatekeeper™ is a bulking agent for fecal incontinence treatment.
- It was previously used for gastroesophageal reflux disease.
- No complications were previously reported for Gatekeeper™ in fecal incontinence treatment.
Purpose of the Study:
- To report complications associated with the Gatekeeper™ bulking agent.
- To highlight potential side effects similar to other bulking agents.
Main Methods:
- A case report of a 52-year-old male patient with fecal soiling.
- The patient received 6 Gatekeeper™ implantations in 2012.
- Endorectal ultrasound and clinical presentation were used for diagnosis.
Main Results:
- The patient experienced temporary improvements followed by prosthesis migration in 2013.
- A perianal abscess containing a prosthesis was diagnosed in 2014.
- The Gatekeeper™ is made of inert Hyexpan and implanted in the intersphincteric region.
Conclusions:
- The Gatekeeper™ may cause prosthesis migration and perianal abscess.
- These complications are similar to those seen with other bulking agents.
- Larger studies are required to assess the Gatekeeper™'s advantages and disadvantages.
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