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Artificial Anal Sphincter Insertion
What is
Artificial Anal Sphincter Insertion?
Artificial sphincter insertion surgery involves
an artificial valve implanted in the anal canal
to re-establish continence and psychological
well-being to patients suffering from anal
sphincter insufficiency which results to severe
fecal incontinence.
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Effects
of Artificial Anal Sphincter Insertion
An
individual's problem of severe fecal
incontinence, through this surgery, would help
facilitate in relieving this problem.
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Candidates for Artificial Anal Sphincter
Insertion
Adults
and children alike suffering from severe
incontinence because of inefficient muscle
contraction of the bowel sphincter may be
benefit from this procedure.
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Your Consultation
A thorough
examination is needed in order to differentiate
the causes of the incontinence and also because
only a few patients suffering from fecal
incontinence would profit from an artificial
sphincter. Vital to the diagnosis of fecal
incontinence are a medical history and physical,
as well as an incontinence diary. A visual
inspection of the anus and the area lying
between the anus and genitals to check for
hemorrhoids, infections, and other conditions is
an essential part of the physical exam. Testing
the strength of the sphincter is also performed.
This is done with the doctor probing with a
finger in order to assess the strength of the
muscle.
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The
Artificial Anal Sphincter Insertion Procedure
During
this open abdominal surgery, the artificial anal
sphincter is placed underneath the skin via
small incisions within the pelvic space. In
between the anus and the vagina (for females) or
scrotum (for males), an incision is placed and
around the neck of the anal sphincter, an
inflatable cuff is positioned. A second incision
is utilized to create a space behind the pubic
bone for positioning of the balloon. This
incision is done at the lower end of the
abdomen. Making use of two incisions, a pump is
placed in a small pocket underneath the labia or
scrotum. The implant device is triggered only
after six to eight weeks in order to facilitate
healing from the procedure. The patient is
instructed in using this device. One is made to
understand that the anal cuff continues to be
inflated in its "resting state" that results in
keeping the anal canal closed by pressure,
therefore, permitting continence. When the
patient has a bowel movement, he or she, in the
interim, deflates the cuff by pressing the pump
which leads to fecal matter being released.
After the bowel movement, the balloon
re-inflates.
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Recovery
In
order to bind the bowels, it is required that
the patient has a few days of dietary
restrictions and anti-diarrheal medications.
Lowering the risk of infection is done by
administering antibiotics, as well as cleaning
of the skin incisions regularly. Patients are
instructed not to lift heavy objects or start
any strenuous activity for about six weeks.
After over six to eight weeks, when the body has
had time to heal, the patient comes back in
order to be instructed and trained in the use of
the pump. It is necessary that the patient
undergo two to three sessions of training after
which the patient is encouraged to lead a normal
life as much as possible.
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Risks
This
procedure is limited to patients who suffer from
a deficient isolated sphincter. Patients who can
undergo this procedure must have little
co-morbidity or serious illnesses and should
trainable in the use of the pump. There is
report of a 30% chance of infection although
this procedure is rather simple.
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Frequently Asked Questions
Q:
Fecal incontinence is caused by what factors?
A:
The failure to control bowel function or what we
call fecal incontinence can be due to several
causes. A complicated childbirth, Crohn's
disease, surgical resection for localized
cancer, neurological injuries, or neurological
disorders are some of them.
Q:
Who suffer from fecal incontinence?
A:
People of different ages may suffer from fecal
incontinence. An estimated 2% of the population
is affected by fecal incontinence although
several cases are never reported. This
condition is more common in women more than five
times as likely as men mainly because of
obstetric injury particularly with forceps
delivery and laceration of the anal sphincter.
Men who have total and subtotal prostatectomies
frequently suffer from fecal incontinence.
People over age 65 commonly suffer from this
condition although it is not necessarily a part
of aging.
Q:
What are the alternatives to this procedure?
A:
Usually, fecal incontinence that is severe
requires surgical intervention depending upon
the underlying disease. This includes anal
sphincter repair and replacement or colostomy.
On the other hand, fecal incontinence that is
mild may be treated by dietary changes and
utilization of certain bowel-binding
medications. Exercise may also help strengthen
and tone the pelvic floor muscles together with
biofeedback in order to train the muscles work
with an appropriate schedule. When all these
measures are utilized, together with the use of
pads, the patient is then advised on the
benefits on an anal sphincter implant.
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The following list of Urology procedures are
performed at Beverly Hills Medical Group -
please click the links to find out more:
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