From the Guidelines
The artificial anal sphincter, also known as Sphincterkeeper, is used for patients with medically-refractory severe fecal incontinence who have failed treatment or are not candidates for other interventions such as barrier devices, sacral nerve stimulation, perianal bulking injection, sphincteroplasty, and a colostomy. This recommendation is based on the best practice advice provided by the Clinical Gastroenterology and Hepatology study 1. The key points to consider when using Sphincterkeeper include:
- It is considered for patients with severe fecal incontinence who have failed conservative treatment and other minimally invasive surgical interventions
- The device works by providing mechanical support to the weakened sphincter muscles, helping to maintain closure of the anal canal and prevent involuntary stool leakage
- Patients who may benefit from Sphincterkeeper include those with sphincter defects or weakness due to childbirth trauma, previous anal surgery, or neurological conditions affecting sphincter control
- The procedure involves implanting the device under local or general anesthesia, typically as an outpatient procedure, and recovery typically takes a few weeks. The use of Sphincterkeeper is supported by the study 1, which provides best practice advice for the treatment of fecal incontinence and defecatory disorders.
From the Research
Sphincterkeeper (Artificial Anal Sphincter) Usage
- The Sphincterkeeper, also known as the artificial anal sphincter, is used for treating faecal incontinence 2, 3, 4, 5.
- It is a surgical technique that involves the implantation of a device to improve outcomes in patients with faecal incontinence 3.
- The device is placed into the intersphincteric space and has been shown to be a safe and effective method for improving patients' quality of life 2.
- Studies have reported improvements in symptoms of faecal incontinence, including reduced episodes of incontinence and improved quality of life scores 3, 4, 5.
Patient Selection and Outcomes
- The Sphincterkeeper is typically used for patients with severe faecal incontinence who have not responded to other treatments 6.
- Patient selection is crucial, and careful consideration should be given to the potential benefits and limitations of the procedure 6.
- Outcomes have varied, with some studies reporting significant improvements in symptoms and quality of life, while others have noted complications and limited success 4, 6, 5.
- Further research is needed to determine the patient cohort most likely to benefit from this procedure and to refine the technique to improve outcomes 3, 4, 5.
Complications and Safety
- Complications have been reported, including device failure, infection, and prosthesis extrusion or migration 4, 6, 5.
- Safety profiles have varied, with some studies reporting no major complications and others noting significant adverse events 3, 4, 6, 5.
- The procedure is generally considered safe, but careful monitoring and follow-up are necessary to minimize the risk of complications 2, 3, 5.