Skip to main content

Troubleshooting Problems After Artificial Anal Sphincter Implantation

  • Chapter
  • First Online:
Reconstructive Surgery of the Rectum, Anus and Perineum

Abstract

The place of the artificial anal sphincter (AAS) is diminishing in the face of other treatments, most notably sacral neuromodulation, which has fewer complications and far less need for operative revision and troubleshooting. The AAS device traditionally has been offered as a last resort for incontinent cases, matching its use in patients with urinary incontinence. This chapter first focuses on AAS implantation techniques and then summarizes the results of a review assessing the efficacy and safety of using AAS for fecal incontinence. Last, it describes the criteria for selecting the most suitable patients for this approach and discusses the place of AAS in the therapeutic algorithm of fecal incontinence management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Christiansen J, Lorentzen M. Implantation of artificial sphincter for anal incontinence. Lancet. 1987;2:244–5.

    Article  PubMed  CAS  Google Scholar 

  2. Mundy L, Merlin TL, Maddern GJ, Hiller JE. Systematic review of safety and effectiveness of an artificial bowel sphincter for faecal incontinence. Br J Surg. 2004;91:665–72.

    Article  PubMed  CAS  Google Scholar 

  3. Wong WD, Congliosi SM, Spencer MP, Corman ML, Tan P, Opelka FG, et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence. Dis Colon Rectum. 2002;45:1139–53.

    Article  PubMed  Google Scholar 

  4. Lehur PA, Meurette G. The artificial bowel sphincter in the treatment of severe fecal incontinence in adults. In: Ratto C, Doglietto G, editors. Fecal incontinence. Diagnosis and treatment. Milan: Springer; 2007.

    Google Scholar 

  5. Michot F, Tuech JJ, Lefebure B, Bridoux V, Denis P. A new implantation procedure of artificial sphincter for anal incontinence: the transvaginal approach. Dis Colon Rectum. 2007;50:1401–4.

    Article  PubMed  Google Scholar 

  6. Michot F, Lefebure B, Bridoux V, Gourcerol G, Kianifard B, Leroi AM, et al. Artificial anal sphincter for severe fecal incontinence implanted by a transvaginal approach: experience with 32 patients treated at one institution. Dis Colon Rectum. 2010;53:1155–60.

    Article  PubMed  CAS  Google Scholar 

  7. O’Brien PE, Dixon JB, Skinner S, Laurie C, Khera A, Fonda D. A prospective, randomized, controlled clinical trial of placement of the artificial bowel sphincter (Acticon Neosphincter) for the control of fecal incontinence. Dis Colon Rectum. 2004;47:1852–60.

    Article  PubMed  Google Scholar 

  8. Parker SC, Spencer MP, Madoff RD, Jensen LL, Wong WD, Rothenberger DA. Artificial bowel sphincter. Long-term experience at a single institution. Dis Colon Rectum. 2003;46:722–9.

    Article  PubMed  Google Scholar 

  9. Melenhorst J, Koch SM, van Gemert WG, Baeten CG. The artificial bowel sphincter for faecal incontinence: a single centre study. Int J Colorectal Dis. 2008;23:107–11.

    Article  PubMed  Google Scholar 

  10. Carmona MDR, Company RA, Vila JVR, Bueno AS, Marti VP. Long-term results of artificial bowel sphincter for the treatment of severe faecal incontinence. Are they what we hoped for? Colorectal Dis. 2009;11:831–7.

    Article  Google Scholar 

  11. Lehur PA, Glemain P, Bruley des Varannes S, Buzelin JM, Leborgne J. Outcome of patients with an implanted artificial anal sphincter for severe faecal incontinence. A single institution report. Int J Colorectal Dis. 1998;13:88–92.

    Article  PubMed  CAS  Google Scholar 

  12. Lehur PA, Roig JV, Duinslaeger M. Artificial anal sphincter: prospective clinical and manometric evaluation. Dis Colon Rectum. 2000;43:1100–6.

    Article  PubMed  CAS  Google Scholar 

  13. Lehur PA, Zerbib F, Neunlist M, Glemain P, Bruley des Varannes S. Comparison of quality of life and anorectal function after artificial sphincter implantation. Dis Colon Rectum. 2002;45:508–13.

    Article  PubMed  Google Scholar 

  14. Wexner SD, Jin HY, Weiss EG, Nogueras JJ, Li VK. Factors associated with failure of the artificial bowel sphincter: a study of over 50 cases from Cleveland Clinic Florida. Dis Colon Rectum. 2009;52:1550–7.

    Article  PubMed  Google Scholar 

  15. Michot F, Costaglioli B, Leroi AM, Denis P. Artificial anal sphincter in severe fecal incontinence: outcome of prospective experience with 37 patients in one institution. Ann Surg. 2003;237:52–6.

    Article  PubMed  Google Scholar 

  16. Finlay IG, Richardson W, Hajivassiliou CA. Outcome after implantation of a novel prosthetic anal sphincter in humans. Br J Surg. 2004;91:1485–92.

    Article  PubMed  CAS  Google Scholar 

  17. Christiansen J, Rasmussen O, Lindorff-Larsen K. Long-term results of artificial anal sphincter implantation for severe anal incontinence. Ann Surg. 1999;230:45–8.

    Article  PubMed  CAS  Google Scholar 

  18. Devesa JM, Rey A, Hervas PL, et al. Artificial anal sphincter: complications and functional results of a large personal series. Dis Colon Rectum. 2002;45:1154–63.

    Article  PubMed  Google Scholar 

  19. O’Brien PE, Skinner S. Restoring control. The Acticon Neosphincter artificial bowel sphincter in the treatment of anal incontinence. Dis Colon Rectum. 2000;43:1213–6.

    Article  PubMed  Google Scholar 

  20. Altomare DF, Dodi G, La Torre F, Romano G, Melega E, Rinaldi M. Multicentre retrospective analysis of the outcome of artificial anal sphincter implantation for severe faecal incontinence. Br J Surg. 2001;88:1481–6.

    Article  PubMed  CAS  Google Scholar 

  21. Gallas S, Leroi AM, Bridoux V, Lefebure B, Tuech JJ, Michot F. Constipation in 44 patients implanted with an artificial bowel sphincter. Int J Colorectal Dis. 2009;24:969–74.

    Article  PubMed  Google Scholar 

  22. Savoye G, Leroi AM, Denis P, Michot F. Manometric assessment of an artificial bowel sphincter. Br J Surg. 2000;87:586–9.

    Article  PubMed  CAS  Google Scholar 

  23. Benoist S, Panis Y, Michot F, Coffin B, Messing B, Valleur P. Artificial sphincter with colonic reservoir for severe anal incontinence because of imperforate anus and short-bowel syndrome: report of a case. Dis Colon Rectum. 2005;48:1978–82.

    PubMed  Google Scholar 

  24. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Members of Committees; Fourth International Consultation on Incontinence. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee, et al. Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anne-Marie Leroi M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Bridoux, V., Michot, F., Leroi, AM. (2013). Troubleshooting Problems After Artificial Anal Sphincter Implantation. In: Zbar, A., Madoff, R., Wexner, S. (eds) Reconstructive Surgery of the Rectum, Anus and Perineum. Springer, London. https://doi.org/10.1007/978-1-84882-413-3_31

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-413-3_31

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-412-6

  • Online ISBN: 978-1-84882-413-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics