Evaluation by three-dimensional anal endosonography of injectable silicone biomaterial (PTQ) implants to treat fecal incontinence: long-term localization and relation with the deterioration of the continence.
BACKGROUND
The purposes of the study were the long-term evaluation of silicone implants with three-dimensional (3D) anal endosonography and its correlation with anal incontinence.


METHODS
Fifteen patients were injected with silicone because of anal incontinence and co-existing internal anal sphincter disruption (n = 8) or thinning (n = 7). The evaluation was performed with the Wexner score and 3D anal endosonographies.


RESULTS
Forty-four implants were performed. The endosonography at 3 months detected that all the implants were properly located. At 24 months, it detected 37/44 implants of initially injected and 33/37 were properly located. Four of 37 implants had moved and 7/44 were neither in the anus nor in the rectum. A total of 8/15 patients had their implants correctly placed. Globally, silicone implants significantly improved fecal continence.


CONCLUSIONS
The silicone implants might have moved or even be lost. The continence deterioration suffered by most patients after the first year of the injection has no relation with the localization and number of implants that the patients have.
de la Portilla
F
F
Department of General Surgery, Hospital Juan Ramón Jiménez, Huelva, Spain. delaportilla@ucphuelva.com
Vega
J
J
Rada
R
R
Segovia-Gonzáles
M M
MM
Cisneros
N
N
Maldonado
V H
VH
Espinosa
E
E
D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging; D000704:Analysis of Variance; D001672:Biocompatible Materials / Q000627:therapeutic use*; D015331:Cohort Studies; D019160:Endosonography / Q000379:methods*; D005242:Fecal Incontinence / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011336:Probability; D019736:Prostheses and Implants; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020034:Silicone Gels / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
D001672:Biocompatible Materials; D020034:Silicone Gels