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Published in: Techniques in Coloproctology 3/2009

01-09-2009 | Original Article

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

Authors: F. de la Portilla, J. Vega, R. Rada, M. M. Segovia-Gonzáles, N. Cisneros, V. H. Maldonado, E. Espinosa

Published in: Techniques in Coloproctology | Issue 3/2009

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Abstract

Background

The purposes of the study were the long-term evaluation of silicone implants with three-dimensional (3D) anal endosonography and its correlation with anal incontinence.

Methods

Fifteen patients were injected with silicone because of anal incontinence and co-existing internal anal sphincter disruption (n = 8) or thinning (n = 7). The evaluation was performed with the Wexner score and 3D anal endosonographies.

Results

Forty-four implants were performed. The endosonography at 3 months detected that all the implants were properly located. At 24 months, it detected 37/44 implants of initially injected and 33/37 were properly located. Four of 37 implants had moved and 7/44 were neither in the anus nor in the rectum. A total of 8/15 patients had their implants correctly placed. Globally, silicone implants significantly improved fecal continence.

Conclusions

The silicone implants might have moved or even be lost. The continence deterioration suffered by most patients after the first year of the injection has no relation with the localization and number of implants that the patients have.
Literature
1.
go back to reference Nelson R, Norton N, Cautley E, Furner S (1995) Community based prevalence of anal incontinence. JAMA 274:559–561PubMedCrossRef Nelson R, Norton N, Cautley E, Furner S (1995) Community based prevalence of anal incontinence. JAMA 274:559–561PubMedCrossRef
2.
go back to reference Rao SS (2004) Pathophysiology of adult fecal incontinence. Gastroenterology 126(1 Suppl 1):S14–S22PubMedCrossRef Rao SS (2004) Pathophysiology of adult fecal incontinence. Gastroenterology 126(1 Suppl 1):S14–S22PubMedCrossRef
3.
go back to reference Shafik A (1993) Polytetrafluoroethylene injection for the treatment of partial fecal incontinence. Int Surg 78:159–161PubMed Shafik A (1993) Polytetrafluoroethylene injection for the treatment of partial fecal incontinence. Int Surg 78:159–161PubMed
4.
go back to reference Shafik A (1995) Perianal injection of autologous fat for treatment of sphincteric incontinence. Dis Colon Rectum 38:583–587PubMedCrossRef Shafik A (1995) Perianal injection of autologous fat for treatment of sphincteric incontinence. Dis Colon Rectum 38:583–587PubMedCrossRef
5.
go back to reference Kumar D, Benson MJ, Bland JE (1998) Glutaraldehyde cross-linked collagen in the treatment of fecal incontinence. Br J Surg 85:978–979PubMedCrossRef Kumar D, Benson MJ, Bland JE (1998) Glutaraldehyde cross-linked collagen in the treatment of fecal incontinence. Br J Surg 85:978–979PubMedCrossRef
6.
go back to reference Altomare DF, La Torre F, Rinaldi M, Binda GA, Pescatori M (2008) Carbon-coated microbeads anal injection in outpatient treatment of minor fecal incontinence. Dis Colon Rectum 51:432–435PubMedCrossRef Altomare DF, La Torre F, Rinaldi M, Binda GA, Pescatori M (2008) Carbon-coated microbeads anal injection in outpatient treatment of minor fecal incontinence. Dis Colon Rectum 51:432–435PubMedCrossRef
7.
go back to reference Spyrou M, De Nardi P (2005) Fecal incontinence after stapled transanal rectotomy managed with Durasphere injection. Tech Coloproctol 9:87 Spyrou M, De Nardi P (2005) Fecal incontinence after stapled transanal rectotomy managed with Durasphere injection. Tech Coloproctol 9:87
8.
go back to reference Ganio E, Marino F, Giani I et al (2008) Injectable synthetic calcium hydroxylapatite ceramic microspheres (Coaptite) for passive fecal incontinence. Tech Coloproctol 12:99–102PubMedCrossRef Ganio E, Marino F, Giani I et al (2008) Injectable synthetic calcium hydroxylapatite ceramic microspheres (Coaptite) for passive fecal incontinence. Tech Coloproctol 12:99–102PubMedCrossRef
9.
go back to reference Malouf AJ, Vaizey CJ, Norton CS, Kamm MA (2001) Internal anal sphincter augmentation for fecal incontinence using injectable silicone biomaterial. Dis Colon Rectum 44:595–600PubMedCrossRef Malouf AJ, Vaizey CJ, Norton CS, Kamm MA (2001) Internal anal sphincter augmentation for fecal incontinence using injectable silicone biomaterial. Dis Colon Rectum 44:595–600PubMedCrossRef
10.
go back to reference Tjandra JJ, Lim JF, Hiscock R, Rajendra P (2004) Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction is effective. Dis Colon Rectum 47:2138–2146PubMedCrossRef Tjandra JJ, Lim JF, Hiscock R, Rajendra P (2004) Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction is effective. Dis Colon Rectum 47:2138–2146PubMedCrossRef
11.
go back to reference de la Portilla F, Fernández A, León E et al (2008) Evaluation of the use of PTQ implants for the treatment of incontinent patients due to internal anal sphincter dysfunction. Colorectal Dis 10:89–94 de la Portilla F, Fernández A, León E et al (2008) Evaluation of the use of PTQ implants for the treatment of incontinent patients due to internal anal sphincter dysfunction. Colorectal Dis 10:89–94
12.
go back to reference Nijhuis PH, van den Bogaard TE, Daemen MJ, Baeten CG (1998) Perianal injection of polydimethylsiloxane (Bioplastique™ Implants) paste in the treatment of soiling. Dis Colon Rectum 41:624–629PubMedCrossRef Nijhuis PH, van den Bogaard TE, Daemen MJ, Baeten CG (1998) Perianal injection of polydimethylsiloxane (Bioplastique™ Implants) paste in the treatment of soiling. Dis Colon Rectum 41:624–629PubMedCrossRef
13.
go back to reference Maeda Y, Vaizey CJ, Kamm MA (2007) Long-term results of perianal silicone injection for faecal incontinence. Colorectal Dis 9:357–361PubMedCrossRef Maeda Y, Vaizey CJ, Kamm MA (2007) Long-term results of perianal silicone injection for faecal incontinence. Colorectal Dis 9:357–361PubMedCrossRef
14.
go back to reference Jorge JMN, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97PubMedCrossRef Jorge JMN, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97PubMedCrossRef
15.
go back to reference Rames RA, Aaronson IA (1991) Migration of polytef paste to the lung and brain following intravesical injection for the correction of reflux. Pediatr Surg Int 6:239–240CrossRef Rames RA, Aaronson IA (1991) Migration of polytef paste to the lung and brain following intravesical injection for the correction of reflux. Pediatr Surg Int 6:239–240CrossRef
16.
go back to reference Malizia AA Jr, Reiman HM, Myerrs RP (1984) Migration and granulomatous reaction after periurethral injection of polytef (Teflon). JAMA 251:3277–3281PubMedCrossRef Malizia AA Jr, Reiman HM, Myerrs RP (1984) Migration and granulomatous reaction after periurethral injection of polytef (Teflon). JAMA 251:3277–3281PubMedCrossRef
18.
go back to reference Smith DP, Kaplan WE, Oyasu R (1994) Evaluation of polydimethysiloxane as an alternative in the endoscopic treatment of vesicoureteral reflux. J Urol 152:1221–1224PubMed Smith DP, Kaplan WE, Oyasu R (1994) Evaluation of polydimethysiloxane as an alternative in the endoscopic treatment of vesicoureteral reflux. J Urol 152:1221–1224PubMed
19.
go back to reference Henley DR, Barret DM, Weiland TL, O′Connor MK, Malizia AA, Wein AJ (1992) Particulate silicone for use in periurethral injections: a study of local tissue effects and a search for migration. J Urol 147:376A Henley DR, Barret DM, Weiland TL, O′Connor MK, Malizia AA, Wein AJ (1992) Particulate silicone for use in periurethral injections: a study of local tissue effects and a search for migration. J Urol 147:376A
Metadata
Title
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
Authors
F. de la Portilla
J. Vega
R. Rada
M. M. Segovia-Gonzáles
N. Cisneros
V. H. Maldonado
E. Espinosa
Publication date
01-09-2009
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 3/2009
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-009-0502-6

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