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


Faecal incontinence occurs when a person loses the ability to control their bowel movements, resulting in leakage of faeces. It can happen as a result of congenital abnormalities of the anal sphincter (the ring of muscle that keeps the anus closed), injury to the sphincter during childbirth or surgery, disease of the nervous system, prolapse of the pelvic organs or pelvic radiotherapy. In this procedure, an inflatable circular cuff is placed in the anorectal area. The cuff is controlled using a pump that is implanted under the skin in the lower half of the abdomen and connected to a reservoir of fluid. Pressure on the pump allows fluid to move to and from the cuff, to open or close the anus and allow bowel movements to be controlled.

Coding recommendations

H57.1 Placement of artificial anal sphincter NEC

Y50.2 Laparotomy approach NEC

Z29.8 Specified part of bowel NEC