Bulking Agents in Faecal Incontinence: Long Term Follow up Results
Lost of faecal control is a very commune condition. Multifactorial causes can determinate faecal incontinence (sphincterial atrophy/atony, neuropathies, sclerosis, spinal damage, iatrogenic, etc). The quality of live, as well as social and working impacts of faecal incontinence are very important. Many surgical options can be avoid for faecal incontinence treatment. The bulking injectable agents represent the most mini invasive treatment that can lead to healing in same case of faecal incontinence. The technique is performed in local anaesthesia in “day surgery”. It consists in silicon polymer injections directly on weak sphincter points. Preoperative investigations and preparation is easy as well. In our experience we performed on enrolled patients to ano-rectal manometry and transanal ultrasound study with 360° rotating with BK probe. Surprisingly, the results in our experience were higher of expectations. The day after the PTQ (polidimetilstilossano/povidone) implants, near all of the patients claim to be extremely satisfied and able to keep and leak free. The long term follow up demonstrated stable results and patients satisfaction. The PTQ implants procedure can be considered a low cost valid minimally invasive option for faecal incontinence treatment able to lead to healing, reducing social costs, improving patients quality of life.
- Bharucha AE, Zinsmeister AR, Locke GR, Seide BM, McKeon K, Schleck CD, Melton LJ: Prevalence and burden of fecal incontinence: a population-based study in women. Gastroenterology. 2005;129(1):42-9.
- Luo C, Samaranayake CB, Plank LD, Bissett IP: Systematic review on the efficacy and safety of injectable bulking agents for passive faecal incontinence. Colorectal Dis. 2010;12(4):296-303.
- Chan MK, Tjandra J: Injectable silicone biomaterial (PTQ) to treat fecal incontinence after hemorrhoidectomy. Dis Colon Rectum. 2006;49(4):433-9.
- Tjandra JJ, Chan MK, Yeh HC: Injectable silicone biomaterial (PTQ) is more effective than carbon-coated beads (Durasphere) in treating passive faecal incontinence-a randomized trial. 2009;11(4):382-9.
- Docimo G, Alfano R, Setaro R, Cimmino F, Lo Jodice F, Graziano M ,Canero A , Docimo L, Lo Schiavo F: Le stenosi post emorroidectomia: quali accorgimenti dal chirurgo proctologo. Colon Proctologia 2000.
- Tjandra JJ, Lim JF, Hiscock R, Rajendra P: Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction is effective. Dis Colon Rectum. 2004;47(12):2138-46.
- Maeda Y, Vaizey CJ, Kamm MA: Long-term results of perianal silicone injection for faecal incontinence. Colorectal Dis. 2007;9(4):357-61.
- Falsetto A, De Pascale V, Della Corte M, Castaldc N, Canero A, Cennamo A: Diathermy haemorrhoidectomy: reasons for a therapeutic choice. Annali Italiani di Chirurgia. 2006:7(2).
- Maeda Y, Vaizey CJ, Kamm MA: Pilot study of two new injectable bulking agents for the treatment of faecal incontinence. Colorectal Dis. 2008;10(3):268-72.
- De la Portilla F, Vega J, Rada R, Segovia-Gonzáles MM, Cisneros N, Maldonado VH, Espinosa E: Evaluation by three-dimensional anal endosonography of injectable silicone biomaterial (PTQ)implants to treat fecal incontinence: long-term localization and relation with the deterioration of the continence. Tech Coloproctol. 2009:13(3):195-9.
- De la Portilla F, Fernández A, León E, Rada R, Cisneros N, Maldonado VH, Vega J, Espinosa E: Evaluation of the use of PTQ implants for the treatment of incontinent patients due to internal anal sphincter dysfunction. Colorectal Dis. 2008 Jan;10(1):89-94.
- Kenefick NJ, Vaizey CJ, MaloufAJ, Norton CS, Marshall M, Kamm MA: Injectable silicone biomaterial for faecal incontinence due to internal anal sphincter dysfunction. Gut. 2002;51(2):225-8.
- Bartlett L, Ho YH: PTQ anal implants for the treatment of faecal incontinence. Br JSurg. 2009;96(12):1948-75.
- Lehur PA, Zerbib F, Neunlist M, Glemair P, Bruley des Varannes S: Comparison of quality of life and anorectal function after artificial sphircter implantation. Dis Colon Rectum. 2002;45(4):508-13.
- Malouf AJ, Vaizey CJ, Norton CS, Kamm MA: Internal anal sphincter augmentation for fecal incontinence using injectable silicone biomaterial. Dis Colon Rectum. 200;44(4);595-600.
- Canero A, De Pascale V, Ambrosio SD, Goffredi L, Cennamo A: Ruolo del PTP nel trattamento dell’incontinenza fecale. Pelvi-Perinealogia, Vol. 25; N°1:45. Marzo 2006.
- Tekkis PP, Herriot AG, Smith JJ, Das P, Canero A, Nicholls RJ: Long term results of abdominal salvage surgery following restorative proctocolectomy. BJS, Vol. 3-Number 2-February 2006.
- Smith JJ, Tekkis PP, Heriot AG, Canero A, Nicholls RJ. Department of Surgery, St.Mark’s Hospital, London, UK: Association of Surgeons of Great Britain and Ireland, Harragate UK, April 2004. Functional outcome & quality of life (QoL) after restorative proctocolectomy (RPC). BJS Abstract.
- de la Portilla, J. Vega, R. Rada, M. M. Segovia-Gonzáles, N. Cisneros, V. H. Maldonado, E. Espinosa. Evaluation by three-dimensional anal endosonography of injectable silicone biomaterial (PTQ™) implants to treat fecal incontinence: long-term localization and relation with the deterioration of the continence. Techniques in Coloproctology volume 13, pages195–199 (2009).
- Canero Antonio
- MD, PhD, Consultant Surgeon, General and Emergency Surgery Department, San Giovanni di Dio and Ruggi D'Aragona University Hospital, Italy, Salerno (firstname.lastname@example.org; )
Canero A. Bulking Agents in Faecal Incontinence: Long Term Follow up Results [Electronic resource] // Acta medica Eurasica. – 2022. – №1. P. 30-38. – URL: http://acta-medica-eurasica.ru/en/single/2022/1/5/. DOI: 10.47026/2413-4864-2022-1-30-38.