Prosthetic Sphincter Battles Incontinence

A new prosthetic device offers a revolutionary approach and solution to dealing with the distressing problem of severe fecal incontinence.

The PAS (prosthetic anal sphincter), manufactured by Biosil (Cumbernauld, UK), is a patented silicone device that reflects the normal action and function of the anal sphincter and pelvic floor muscles. The PAS device aims to overcome the risk of ischemic complications by simulating the normal physiology of the ano-rectum and reproducing the action of the puborectalis muscle by flattening and angulating the bowel without causing crenation, scalloping of the curved surface of the bowel.

The PAS design is comprised of three main components, based on the present understanding of the dynamics of flow of solids and semi-solids. These include a textured silicone sphincter cuff that when inflated, gently flattens the bowel against a cohesive gel-filled soft pillow; a pressure-regulating reservoir balloon to provide the hydraulic pressure source to drive the system; and a control pump that allows movement of fluid to and from the sphincter, to open (deactivate) or close (activate) the device.

The prosthetic anal sphincter, which could significantly increase quality of life for sufferers of incontinence, was developed over a period of 10 years by Glasgow (Scotland, UK) colorectal surgeon Ian Finlay. Previous attempts to develop and introduce an artificial sphincter have been limited in their success, mainly as a result of damage to the bowel caused by high pressures within the device and subsequent loss of blood supply.

Fecal Incontinence is a common, distressing clinical condition that affects between 2-7% of the population of the western world, commonly caused by birth defects, injury, or even degeneration of muscle over time.



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