The surgical treatment of fecal incontinence with artificial anal sphincter implant. Preliminary clinical report.
OBJECTIVE
Fecal incontinence has a serious impact upon patients' quality of life. Several treatment methods are possible according to the pathophysiology of the disease.


METHODS
Between March 1999 and February 2002 eight artificial anal sphincters (American Medical System - AMS) were implanted in seven patients affected with severe fecal incontinence; in one case the device was positioned in a patient who had previously undergone a Miles' resection. All cases were carefully selected according to appropriate diagnostic evaluation. The follow-up varies between 3 and 40 months.


RESULTS
The prosthesis had to be removed in two cases; in one patient infection of the implant area occurred, while in the other case persistent perianal pain due to the presence of the device could not be tolerated by the patient. In the six patients that could be successfully treated with the artificial anal sphincter implant, it dramatically improved their quality of life.


CONCLUSIONS
The success of the procedure allows the consideration that the artificial anal sphincter implant is the best treatment for severe fecal incontinence that cannot be solved with conservative therapy.
La Torre
F
F
Department of Surgical Sciences, University of Rome La Sapienza, Italy. latorre@uniroma1.it
Masoni
L
L
Montori
J
J
Ruggeri
E
E
Montori
A
A
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D020878:Device Removal; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D019919:Prosthesis Implantation; D011788:Quality of Life; D012086:Reoperation