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Artificial anal sphincter implantation

Guidance issued Guidance issued
 
IP Guidance Number: IPG66
 
Summary:

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on artificial anal sphincter implantation.

Description:

Artificial anal sphinters are used to treat severe faecal incontinence.  A range of other treatments for faecal incontinence are available including medical therapy, biofeedback training and surgery. Surgical treatment options include sphincter repair, sacral nerve stimulation, encirclement procedures, muscle transposition (dynamic graciloplasty), implantation with an artificial anal (bowel) sphincter, or diversion surgery (colostomy).

The cuff is inserted around the upper anal canal and tubing from the cuff is channelled along the perineum and connected to a control pump placed subcutaneously in the scrotum or labia. The control pump is then connected by tubing to a pressure-regulating balloon that has been implanted in the abdominal wall. The balloon holds approximately 40ml of radio-opaque solution and the control pump regulates the transfer of fluid from the balloon to the cuff so that when the cuff is filled with fluid, continence is achieved. By pressing the pump several times, fluid is displaced from the cuff back to the balloon, allowing defaecation. Once defaecation is complete, the fluid slowly returns to the cuff and continence is again achieved.

Arrangements:

Other (see guidance)

Topic Area:

Digestive system
Surgical procedures

Specialty:

Gastro-enterology

Specialist advice has
been sought from:
Association of Coloproctology of Great Britain and Ireland
Date notified to NICE: 01 April 2002
Guidance Publication Date: 23 June 2004
Contact Details:
Project Manager
(for general enquiries or comments)
Ben Doak
ip@nice.org.uk
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA


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