Artificial anal sphincter implantation

Summary

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on artificial anal sphincter implantation.

Description

Artificial anal sphinters are used to treat severe faecal incontinence.  A range of other treatments for faecal incontinence are available including medical therapy, biofeedback training and surgery. Surgical treatment options include sphincter repair, sacral nerve stimulation, encirclement procedures, muscle transposition (dynamic graciloplasty), implantation with an artificial anal (bowel) sphincter, or diversion surgery (colostomy).

The cuff is inserted around the upper anal canal and tubing from the cuff is channelled along the perineum and connected to a control pump placed subcutaneously in the scrotum or labia. The control pump is then connected by tubing to a pressure-regulating balloon that has been implanted in the abdominal wall. The balloon holds approximately 40ml of radio-opaque solution and the control pump regulates the transfer of fluid from the balloon to the cuff so that when the cuff is filled with fluid, continence is achieved. By pressing the pump several times, fluid is displaced from the cuff back to the balloon, allowing defaecation. Once defaecation is complete, the fluid slowly returns to the cuff and continence is again achieved.

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Details

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Links:

	IPG66 Artificial anal sphincter: guidance	21 June 2004
	IPG66 Artificial anal sphincter: understanding NICE guidance	21 June 2004
	IPG66 Mewnblannu sffincter rhefrol artiffisial: deall canllawiau NICE	13 May 2009
	IPG66 Artificial anal sphincter: distribution list	21 July 2004
	Interventional procedure consultation document - artificial anal sphincter	27 January 2004
	Consent - procedures for which the benefits and risks are uncertain	27 November 2003
	Overview of artificial anal sphincter	23 January 2004