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NICE identifies lack of evidence for use of artificial bowel sphincter implantation

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New NICE guidance recommends that use of transabdominal artificial bowel sphincter implantation for the treatment of faecal incontinence should be restricted because of lack of evidence.

Evidence to support the safety and efficacy of transabdominal artificial bowel implants is limited to a small number of patients and is inadequate according to NICE interventional procedure guidance.

The guidance recommends that clinicians wishing to undertake the procedure for facecal incontinence should;

  • Inform the clinical governance leads in their trust,
  • Ensure that patients understand the evidence supporting the procedure and provide clear written information,
  • Use the NICE information for patients leaflet
  • Audit and review clinical outcomes for all patients who have the procedure.

Faecal incontinence has a number of causes including childbirth, neurological or spinal disease and pelvic organ prolapse. First line treatment includes, dietary modification and antidiarrhoeal medicines as well as pelvic floor muscle training, biofeedback and electrical stimulation. Local surgery may be used to repair the sphincter and if this fails further measures including transabdominal artificial sphincters may be considered.

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