Skip to main content
SpringerLink
Log in

Artificial anal sphincter

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: This study was undertaken to evaluate the use of a fully implanted artificial anal sphincter for management of severe fecal incontinence. METHODS: An artificial anal sphincter was implanted in 12 patients who failed conventional management for severe fecal incontinence. Careful patient follow-up was recorded during a mean 58-month follow-up. Patients underwent preoperative and postoperative manometric assessment. Functional and patient satisfaction evaluations were obtained by mailed questionnaire. RESULTS: Three infections and three mechanical complications occurred in four patients (33 percent). A successful outcome was achieved in nine patients (75 percent). Postoperative manometric studies documented establishment of an elevated high-pressure zone compared with preoperative resting pressures. Seven patients returned a detailed functional assessment and patient satisfaction questionnaire at a mean of 40 months postsphincter activation. All seven patients reported continence to solid stool. Two patients had some problems with control of liquid stool, and three had occasional incontinence to flatus. Six of the seven patients rated their bowel control as good to excellent. All seven respondents were satisfied with their functional improvement. CONCLUSIONS: Early experience with an artificial anal sphincter has demonstrated that continence can be restored with acceptable morbidity in patients with severe fecal incontinence.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Congilosi SM, Wong WD. Anal incontinence. In: Cameron JL, ed. Current surgical therapy. 5th ed. St. Louis: Mosby-Year Book, 1995:240–5.

    Google Scholar 

  2. Fang DT, Nivatvongs S, Vermeulen FD, Herman FN, Goldberg SM, Rothenberger DA. Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum 1984;27:720–2.

    PubMed  CAS  Google Scholar 

  3. Motson RW. Sphincter injuries: indications for and results of sphincter repair. Br J Surg 1985;72(Suppl):S19–21.

    PubMed  Google Scholar 

  4. Corman ML. Anal incontinence following obstetrical injury. Dis Colon Rectum 1985;28:86–9.

    PubMed  CAS  Google Scholar 

  5. Baeten CG, Geerdes BP, Adang EM,et al. Anal dynamic graciloplasty in the treatment of intractable fecal incontinence. N Engl J Med 1995;332:1600–5.

    PubMed  CAS  Google Scholar 

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

    Google Scholar 

  7. Christiansen J, Lorentzen M. Implantation of artificial sphincter for anal incontinence: report of five cases. Dis Colon Rectum 1989;32:432–6.

    PubMed  CAS  Google Scholar 

  8. Christiansen J, Sparso B. Treatment of anal incontinence by an implantable prosthetic anal sphincter. Ann Surg 1992;215:383–6.

    PubMed  CAS  Google Scholar 

  9. Orrom WJ, Wong WD, Rothenberger DA, Jensen LL. Evaluation of an air-filled microballoon and minitransducer in the clinical practice of anorectal manometry: preliminary communication. Dis Colon Rectum 1990;33:594–7.

    PubMed  CAS  Google Scholar 

  10. Scott FB, Bradley WE, Tim GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology 1973;1:252–9.

    PubMed  CAS  Google Scholar 

  11. Scott FB. The artificial urinary sphincter: experience in adults. Urol Clin North Am 1989;16:105–17.

    PubMed  CAS  Google Scholar 

  12. Chandler JG, Adams RB, Friedman CJ, Marcella KL, Guerrant RL. Assessment of an implantable ileostomy sphincter. Surgery 1985;98:72–80.

    PubMed  CAS  Google Scholar 

  13. Delaney J, Broadie T, Timm G, Bradley W. A prosthetic sphincter for the gastrointestinal tract. J Surg Res 1974;16:204–9.

    PubMed  CAS  Google Scholar 

  14. Heiblum M, Cordoba A. An artificial sphincter: a preliminary report. Dis Colon Rectum 1978;21:562–6.

    PubMed  CAS  Google Scholar 

  15. Szinicz G. Anew implantable sphincter prosthesis for artificial anus. Int J Artif Organs 1980;3:358–62.

    PubMed  CAS  Google Scholar 

  16. Light JK, Scott FB. The artificial urinary sphincter in children. Br J Urol 1984;56:54–7.

    Article  PubMed  CAS  Google Scholar 

  17. Burbige KA, Reitelman C, Olsson CA. Complications of artificial urinary sphincter around intestinal segments in reconstructed exstrophy patients. J Urol 1987;138:1123–7.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, University of Minnesota Medical School, Minneapolis, Minnesota

    W. Douglas Wong M.D., Linda L. Jensen R.N. & David A. Rothenberger M.D.

  2. Department of Surgery, Royal Infirmary, Edinburgh, Scotland

    David C. C. Bartolo M.S., F.R.C.S.

Authors
  1. W. Douglas Wong M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linda L. Jensen R.N.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David C. C. Bartolo M.S., F.R.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David A. Rothenberger M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported by American Medical Systems, Minneapolis, Minnesota.

About this article

Cite this article

Wong, W.D., Jensen, L.L., Bartolo, D.C.C. et al. Artificial anal sphincter. Dis Colon Rectum 39, 1345–1351 (1996). https://doi.org/10.1007/BF02054522

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02054522

Key words

Search

Navigation