Artificial Bowel Sphincter Implantation for Faecal Incontinence in Asian Patients

BACKGROUND: To evaluate the outcomes with the American Medical Systems artificial bowel sphincter (ABS) implantation for the treatment of intractable faecal incontinence in an Asian population. METHODS: Six Asian patients who underwent ABS implantation between March 2004 and December 2007 for the treatment of faecal incontinence were reviewed. RESULTS: The ABS was successfully implanted in six patients [mean age SO (20-73) years; 4 males]. The most common causes of incontinence were congenital anomaly of the anus (imperforate anus status post a pull-through procedure) and status-post ultralow anterior resection. Two patients required device explantation due to postoperative infection. One eventually required a colostomy. After a mean follow-up of 22 (4-36) months, four patients continued to have a functional artificial bowel sphincter. Faecal incontinence severity scores improved from a mean of 13 (12-14) to 6 (0-9) postactivation. Anal manometry showed an increase in mean resting pressures (19.2 +/- 7.5 mmHg vs. postirnplantation with cuff inflated 45.0 +/- 12.0 mmHg). The comparative preoperative and postactivation faecal incontinence quality of life scores showed improvement in all aspects. CONCLUSIONS: Patients with successful ABS implantation benefited from improved outcomes in function and quality of life. Infection was the most common cause of failure in our patients. [Asian J Surg 2010;33(3):134-42]