The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

PTQ™ anal implants for the treatment of faecal incontinence. BJS 2009; 96: 1468-1475.

Published: 13th November 2009

Authors: L. Bartlett, Y.‐H. Ho

Background

In North Queensland demand for conservative faecal incontinence treatments outweighs supply. Injectable bulking agents offer a safe and effective treatment for patients with internal anal sphincter (IAS) dysfunction.

Method

Information, including age and sex, baseline incontinence score, quality of life, resting and squeeze pressures, was collected for 74 patients (37 men) who received intersphincteric PTQ injections. Postimplant satisfaction was assessed at 6‐week review. Incontinence scores and satisfaction ratings were determined annually.

Results

At a median follow‐up of 28 months, 52 patients (70 per cent) with IAS dysfunction who received PTQ anal implants as a treatment for faecal incontinence were continent and extremely satisfied with the result. The incontinence score in participants who remained incontinent was reduced significantly from 12 of 20 before implant to 3·5 of 20 at follow‐up (P < 0·001). Migration rates improved with experience. The poorest results occurred in women with pudendal neuropathy, or patients who had previously received biofeedback treatment.

Conclusion

Implanted PTQ provides an effective solution to faecal incontinence in the short and mid term for patients with IAS dysfunction. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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