ABSTRACT

Faecal incontinence is a significant and a very debilitating condition. The true prevalence of which is unknown but up to 3% of the general population have stool incontinence which increases with age. Faecal incontinence is much more common in women, increases with parity, and up to 30% have associated urinary incontinence and/or pelvic organ prolapse. Patients who have an identifiable external sphincter defect who fail conservative treatment options are best managed by a primary repair of the defect. This study presents a novel way of supporting the external anal sphincter with a circlage tape prosthesis. Based on the success of tension-free suburethral tapes used to treat stress urinary incontinence a pilot study was devised to assess Anal Sphincter Support System (ASSP) in patients presenting with mild faecal incontinence. Fourteen patients were followed up for a mean period of eighteen months. Outcomes were very encouraging with resolution of symptoms between 70 and 100%. There were no observed complications. This pilot study demonstrates that the ASSP provides a safe and effective method of restoring anal continence and can be used successfully with concomitant procedures which may be necessary for restoration of pelvic floor anatomy and function.