IPG66

Artificial anal sphincter implantation (IPG66)

  • Interventional procedures IPG66
  • Issued: June 2004
    • Artificial anal sphincter implantation

      The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on artificial anal sphincter implantation in June 2004. In accordance with the Interventional Procedures Programme Process Guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

      The guidance was considered for reassessment in June 2007 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.

      • 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.

      • OPCS4.6 Code(s)

        H57.1 Placement of artificial anal sphincter NEC

        Note: The following two procedures can also be coded in OPCS-4: H57.2 Maintenance of artificial anal sphincter NEC or H57.3 Removal of artificial anal sphincter NEC.

        The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

         

      • Other information

      This page was last updated: 04 April 2011

    • Guidance formats

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      Information for the public Artificial anal sphincter implantation

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Implementation tools and resources

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Patient

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Quick Reference Guide

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NICE Guidance

The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.

Full Guidance

The published full clinical guidance for specialists with background, evidence, recommendations and methods used.

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.