title: Experience with a new prosthetic anal sphincter in three coloproctological centres.
abstract: BACKGROUND
  Fecal incontinence is a common and severely disabling disorder. For patients with severe fecal incontinence, surgery may prove to be the only adequate treatment option.
  
  
  METHODS
  This study reports on 43 patients that were treated with a prosthetic sphincter system between 2005 and 2009 in three coloproctological centres.
  
  
  METHODS
  complications, anal pressures before and after surgery, fecal continence score.
  
  
  RESULTS
  The new artificial sphincter system significantly improves continence but leads to some complications in clinical practice. After implantation of the device, continence improved significantly (Keller & Jostarndt continence score 2.6 to 14.3 (P < 0.01)). With the band activated, resting pressure improved significantly as compared to baseline (10.7 mmHg vs. 66.1 mm Hg, P < 0.01). The same holds for anal sphincter squeeze pressure (32.2 mmHg versus 85.9 mm Hg, P < 0.01). Complications occurred in 21 patients (48.8%): 10 surgical and 13 technical. Two patients were affected by both technical and surgical problems. The median time of the occurrence was 3 months postop. In five patients difficulties arose within the first postoperative month leading to explantation of the device in three patients. 90% of complications occurred in the first year.
  
  
  CONCLUSIONS
  The soft anal band of AMI (AAS), a new artificial anal sphincter, improves severe anal incontinence, but it must be regarded as a last treatment option to avoid a stoma.
authors: Department for General and Visceral Surgery, University Hospital Freiburg im Breisgau, Hugstetter Straße 55, 79106, Freiburg im Breisgau, Baden-Württemberg, Germany. matthias.goos@uniklinik-freiburg.de.
authors: Matthias
authors: M
authors: Goos
authors: Ulrich
authors: U
authors: Baumgartner
authors: Mathias
authors: M
authors: Löhnert
authors: Oliver
authors: O
authors: Thomusch
authors: Günther
authors: G
authors: Ruf
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011312:Pressure; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012828:Silicones; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D012828:Silicones; D014025:Titanium