Evaluation of the use of PTQ implants for the treatment of incontinent patients due to internal anal sphincter dysfunction.
OBJECTIVE
This study reports the results of injectable silicone PTQ implants for faecal incontinence due to internal anal sphincter (IAS) dysfunction.


METHODS
Twenty patients (12 women) with partial faecal incontinence aged from 55 to 65 years were treated by a PTQ implant. All patients completed the Cleveland Clinic Continence and Quality of Life questionnaire. Endoluminal ultrasound and anorectal physiological testing were performed in each patient. All implants were inserted into the submucosal plane without ultrasound guidance.


RESULTS
Faecal continence was significantly improved up to 1 year. The Wexner continence score fell from a median of 13.05 (range, 5-20) before treatment to 4.5 (range 2-7.7) at 1 month after (P < 0.005). This rose gradually to 6.2 (range, 0-16) at one year (P = 0.02) and 9.4 (range, 1-20) at 2 years (P = 0.127). There were no differences in resting or squeeze pressure before and at 3 months after treatment (P = 0.86 and P = 0.93). Fourteen (70%) patients experienced pruritus ani during the first few weeks after the procedure and one developed infection at the implant site.


CONCLUSIONS
Silicone implantation is minimally invasive and technically simple. It is effective over 1 year in the treatment of faecal incontinence due to IAS dysfunction.
de la Portilla
F
F
Coloproctology Unit, Department of General Surgery, Hospital Juan Ramón Jiménez, Huelva, Spain.
Fernández
A
A
León
E
E
Rada
R
R
Cisneros
N
N
Maldonado
V H
VH
Vega
J
J
Espinosa
E
E
D000368:Aged; D001003:Anal Canal / Q000187:drug effects* / Q000503:physiopathology; D001672:Biocompatible Materials / Q000494:pharmacology / Q000627:therapeutic use*; D004129:Dimethylpolysiloxanes / Q000494:pharmacology / Q000627:therapeutic use*; D019160:Endosonography / Q000379:methods; D005242:Fecal Incontinence / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011336:Probability; D011351:Proctoscopy / Q000379:methods; D019736:Prostheses and Implants; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D001672:Biocompatible Materials; D004129:Dimethylpolysiloxanes