The investigators prospectively assessed the complications and functional outcome following artificial anal sphincter implantation.
They reported their findings in the July issue of the British Journal of Surgery.
A total of 24 artificial anal sphincters (Acticon Neosphincter) were implanted in 22 patients (mean age 47 years).
The mean follow-up period was 28 (range 6-48) months.
Two independent observers assessed results at 4-month intervals.
The team found that 5 patients were completely free of complications.
During the postoperative period, complications occurred in 9 patients, 2 of whom required reoperation.
| Probability of device explantation at 4 years: 44%.
| British Journal of Surgery |
Furthermore, during follow-up, complications developed in 10 patients, 9 of whom were reoperated.
Definitive device explantation was necessary in 7 patients.
The researchers calculated that the cumulative probability of device explantation was 44% at 48 months.
The 15 patients with functioning implants were followed up for a mean of 26 months.
In these, continence grading improved from a mean of 18 in the preoperative period to 4 after operation.
In addition, resting anal canal pressure in patients with a functioning implant increased from a mean of 35 mm Hg before operation to 54 mm Hg after implantation.
Dr H. Ortiz, of the Public University of Navarre, Pamplona, concluded on behalf of fellow authors, "An artificial anal sphincter is a useful alternative for refractory fecal incontinence. However, the incidence of late postoperative complications is high."