Anal incontinence treatment with artificial anal band system

Abstract

Fecal (anal) incontinence is defined as involuntary loss of anal sphincter control in a socially inappropriate time and condition. The fear of such an event limits social and physical activity. Inability to do daily activities cause social isolation and results in a reduced quality of life. Because of embrassment and stigmatization, the affected individuals often `suffer in silence`. Consequently, reported prevalence rates likely underestimate the true extent. Many different methods of treatment has been used with limited success and several complications have been reported as the procedures used become more complex and invasive. These modalities take place in a large range beginning from dietary interventions and bio-feedback and ending with surgical procedures of muscle interposition and artificial banding mechanisms. In our Department of General Surgery at Marmara University School of Medicine, we investigated the effect of artificial anal band use on quality of life of artificial anal band implanted fecal incontinence patients. This was a pilot study of limited number of patients with severe fecal incontinence using the modality of artificial anal band for treatment. Five of eight (62,5%) succesfully implanted patients were able to use their anal bands effectively. The preoperative Cleveland Clinic Incontinence Scores (CCIS) were significantly improved after implantation. Preoperatively recorded fecal incontinence quality of life scores were compared to the scores recorded 2 weeks after the activation of the anal band and these also were improved significantly. Fecal incontinence is a severe social and physical problem. Artificial anal band implantation is an effective treatment option to improve quality of life in fecal incontinence patients. Appropriate patient`s selection may increase the rate of effective use of artificial anal band in this special disease.