An external device for faecal incontinence.
OBJECTIVE
The aim of the study was to describe a simple external device that enables the incontinent patient to control the time, frequency and place of defecation.


BACKGROUND
The device is based on the principle of a "ball & socket" valve. The "ball" is an inflatable silastic balloon while the "socket" is the anorectal junction. The device can be used with minor modifications in patients with terminal colostomy to make them continent and avoid the need for colostomy bags.


METHODS
The inflatable plug has been used successfully in eighteen incontinent children for a period ranging from six months to 8 years. The child decides the amount of air inside the inflatable plug that is comfortable and yet adequate to prevent soiling. This usually ranged between 10 to 25 cm of air.


RESULTS
To date, the device has been manufactured manually. All the children tolerated the plug without discomfort. Deflation of the balloon occurred after 3 - 5 days of use due to defective manufacturing. None of the patients developed ischaemia of the bowel or skin excoriations.


CONCLUSIONS
This conservative, simple, inflatable plug enhances both qualitative and quantitative faecal continence in children with faecal soiling. An improvement in quality of life was also perceived by the patients and their parents. Better manufacturing may improve the results.
Hadidi
A T
AT
Department of Paediatric Surgery, Heidelberg University, Mannheim, Germany. athadidi@yahoo.de