Dataset Information

Palpable abdominal mass and recurrent fecal incontinence due to failure of artificial bowel sphincter.

ABSTRACT: Artificial bowel sphincters (ABS), specifically the Acticon Neosphincter, have been used to treat fecal incontinence (FI) since the early 2000s. This report and literature review focuses on possible device malfunctions of previously placed ABS for FI. We present a case of device malfunction in a patient with FI who had a previously placed ABS, review relevant literature, and discuss outcomes of ABS placement with possible device malfunctions.

SUBMITTER: Zellmer T

PROVIDER: S-EPMC6199762 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Palpable abdominal mass and recurrent fecal incontinence due to failure of artificial bowel sphincter.

Zellmer Tim T MacDonald William W

Radiology case reports 20181017 1

Artificial bowel sphincters (ABS), specifically the Acticon Neosphincter, have been used to treat fecal incontinence (FI) since the early 2000s. This report and literature review focuses on possible device malfunctions of previously placed ABS for FI. We present a case of device malfunction in a patient with FI who had a previously placed ABS, review relevant literature, and discuss outcomes of ABS placement with possible device malfunctions. ...[more]

PMID: 30364912

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Project description:IntroductionA prospective evaluation of outcomes in a series of patients with post-prostatectomy incontinence (PPI) treated with two different devices is presented.MethodsConsecutive patients with PPI underwent interventions with an adjustable transobturator male system (ATOMS) or artificial urinary sphincter (AUS). Decisions were based on patient preference after physician counselling. Patient characteristics and operative and postoperative parameters including dryness, satisfaction, complications, revision and device durability were evaluated.ResultsOne hundred twenty-nine patients were included: 102 (79.1%) received ATOMS and 27 (20.9%) AUS. Mean follow-up was 34.9 ± 15.9 months. No difference was observed between patient age (p = 0.56), ASA score (p = 0.13), Charlson index (p = 0.57) and radiation (p = 0.3). BMI was higher for AUS (27.1 vs. 29.7; p = 0.003) and also baseline incontinence severity (7.9% mild, 44.1% moderate and 48% severe for ATOMS vs. 11.1% moderate and 88.9% severe for AUS; p = 0.0007). Differential pad test was higher for AUS (- 470 vs. - 1000 ml; p < 0.0001) and so was ICIQ-SF (15.62 vs. 18.3; p < 0.001), but total dryness (76.5 vs. 66.7%; p = 0.33), social continence (90.2 vs. 85.2%; p = 0.49) and satisfaction (92.2 vs. 88.9%; p = 0.69) were equivalent. The postoperative complication rate was similar (22.6 vs. 29.6%; p = 0.4). The surgical revision rate was higher for AUS (6.9 vs. 22.2%; p = 0.029) and also the explant rate but did not reach statistical significance (4.9 vs. 14.8%; p = 0.09). Time to explant was shorter for AUS (log-rank p = 0.021). Regression analysis revealed radiation (p = 0.003) and incontinence severity (p = 0.029) predict total dryness, while complications (p < 0.005) and type of device (p = 0.039) independently predict surgical revision.ConclusionsBoth ATOMS and AUS are effective devices. Pad test change for AUS exceeds that of ATOMS. The revision rate is higher for AUS, and durability is superior for ATOMS. The satisfaction rate is equivalent. Larger series and longer follow-up are needed to compare both devices more appropriately. According to our experience, the AUS is not the only gold standard for PPI.

Dataset Information

Palpable abdominal mass and recurrent fecal incontinence due to failure of artificial bowel sphincter.

Publications

Palpable abdominal mass and recurrent fecal incontinence due to failure of artificial bowel sphincter.

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