PURPOSE: An attenuated or disrupted anal sphincter can lead to faecal incontinence. One means of augmenting the sphincter is with the use of the silicone-based biomaterial PTQ. The aim of this study was to evaluate the effectiveness of PTQ for the symptoms of passive faecal incontinence caused by a weak sphincter mechanism.
METHODS: The patient records of 37 patients with passive faecal incontinence treated by 2 surgeons were examined. Their faecal incontinence scores were recorded from pre-operative consultations and then in a follow-up phone interview. Any adverse effects of treatment were recorded including significant pain, development of perianal abscesses and loss of injected silicone.
RESULTS: Thirty-seven patients received PTQ injections and completed follow up interviews. The main cause of faecal incontinence for this group was obstetric trauma. The follow-up period was from 1–43 months with a median of 9 months. Twenty-five patients experienced improvements in their faecal incontinence with 7 patients remaining unchanged and 5 worse symptomatically. The median improvement in faecal incontinence scores was 3 with an average of 3.76. It was important to note that the improvement was more
marked in follow-up over 18 months, with an average of 4.5. Four patients developed post injection abscesses, the most common adverse outcome and these were successfully treated with surgical drainage.
CONCLUSION: PTQ injections are a successful and minimally invasive treatment in the management of passive faecal incontinence. Two thirds of patients were improved with the injection of PTQ. Ten percent of the patients developed injection related abscesses.
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