title: Does the magnetic anal sphincter device compare favourably with sacral nerve stimulation in the management of faecal incontinence?
abstract: OBJECTIVE
  The magnetic anal sphincter (MAS) is a recent surgical innovation for severe faecal incontinence (FI). With its place in the treatment algorithm of FI yet to be defined, we report a nonrandomized comparison between MAS and sacral nerve stimulation (SNS) in a single-centre cohort of patients with FI.
  
  
  METHODS
  Data were reviewed from prospective databases. From December 2008 to December 2010, 12 women [median age 65 (42-76) years], having FI for a median of 6.5 years, were implanted with a MAS. Sixteen women, of similar age, preoperative function scores, aetiology and duration of incontinence, and implanted with a permanent SNS pulse generator during the same period, served as a reference group. The duration of hospital stay, complications, change in incontinence and quality of life scores and anal physiology were compared between the two groups.
  
  
  RESULTS
  The duration of follow up was similar [MAS = 18 (8-30) months vs SNS = 22 (10-28) months; P = 0.318]. Four patients with MAS experienced a 30-day complication, and the device was removed from one patient in each group. A significant improvement in incontinence (P < 0.001) and quality-of-life scores (P < 0.04) occurred in both groups. Mean anal resting pressure increased significantly in patients implanted with a MAS (P = 0.027).
  
  
  CONCLUSIONS
  In this single-centre nonrandomized cohort of FI patients, MAS was as effective as SNS in improving continence and quality of life, with similar morbidity. These results can now serve as a prelude to a randomized trial comparing the procedures.
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, University Hospital of Nantes, Nantes, France.
authors.forename: M T C
authors.initials: MT
authors.lastname: Wong
authors.forename: G
authors.initials: G
authors.lastname: Meurette
authors.forename: V
authors.initials: V
authors.lastname: Wyart
authors.forename: P-A
authors.initials: PA
authors.lastname: Lehur
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology*; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D058542:Implantable Neurostimulators / Q000009:adverse effects; D007902:Length of Stay; D008160:Lumbosacral Plexus; D059346:Magnets / Q000009:adverse effects; D008365:Manometry; D008875:Middle Aged; D019736:Prostheses and Implants; D011788:Quality of Life; D018709:Statistics, Nonparametric