PTQ anal implants for the treatment of faecal incontinence.

Abstract

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. 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. 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. Implanted PTQ provides an effective solution to faecal incontinence in the short and mid term for patients with IAS dysfunction.