Long-term results of perianal silicone injection for faecal incontinence

Abstract

Objective: Perianal injection of bulking agents is a simple method for treating passive faecal incontinence. To date only short-term results of treatment are available. This study is the first to determine the efficacy of silicone biomaterial (PTQ; Uroplasty BV, Geleen, The Netherlands) injection in the long term.

Method: Six patients, median age 53 years at the time of injection with PTQ, were followed up at 61 months. A validated faecal incontinence score, treatment-specific questionnaire and SF-36 health survey questionnaire were completed.

Results: At 61-month follow up one patient had undergone a colostomy for faecal incontinence. In the remaining five patients the incontinence score was little changed: 11 (8-20) vs 13 (9-19) [pre v at 61 months, median (range)]. However, there was a substantial improvement in physical and social function on the SF-36 scores. Satisfaction scores were high at a median 7 of 10 (range: 0-8). Subjectively, three patients were improved; one of these had undergone a further set of injections and one improved after a course of biofeedback. After the follow-up period one of the five patients had a colostomy for recto-vaginal fistula.

Conclusion: The results of perianal injection of PTQ for passive faecal incontinence are variable in the long term. More extensive evaluation in the short term, and possibly repeated treatment, may be required.