ABSTRACT
In patients with severe destruction of the external anal sphincter or pelvic floor, or failure of local repair, transposition of skeletal muscle may be carried out with acceptable result. Patients in whom these procedures fail may be helped by implantation of an artificial sphincter. The artificial sphincter used in the first patients was an unmodified artificial urinary sphincter, but due to the different dimensions and pressure conditions of the anal canal and the urethra, some modifications have been necessary. The sphincter consists of a cuff which is placed around the anal canal, a pressure-regulating balloon, and a pump placed in the scrotum or labium majus, by which the patient can inflate and deflate the cuff. The present modification of the artificial sphincter seems to have overcome the initial mechanical problems that necessitated repeated revisional procedures.
